Healthcare Provider Details
I. General information
NPI: 1508280322
Provider Name (Legal Business Name): PATHWAYS TO WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2014
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
312 APPLEGARTH RD
MONROE NJ
08831-5347
US
IV. Provider business mailing address
43 LINWOOD DR
MONROE NJ
08831-3788
US
V. Phone/Fax
- Phone: 732-655-4239
- Fax:
- Phone: 609-245-8550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GAGANDEEP
SINGH
Title or Position: OWNER
Credential: MD
Phone: 908-675-6010