Healthcare Provider Details

I. General information

NPI: 1376737361
Provider Name (Legal Business Name): PATHWAYS BEHAVIORAL HEALTH SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2007
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 HALLS CREEK RD
NEW BERN NC
28560-5722
US

IV. Provider business mailing address

594 HALLS CREEK RD
NEW BERN NC
28560-5722
US

V. Phone/Fax

Practice location:
  • Phone: 252-745-5761
  • Fax: 252-745-7750
Mailing address:
  • Phone: 252-745-5761
  • Fax: 252-745-7750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL069006
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL069006
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberMHL069006
License Number StateNC

VIII. Authorized Official

Name: MR. JIMMIE HILL
Title or Position: C EO
Credential:
Phone: 252-745-5761