Healthcare Provider Details

I. General information

NPI: 1952816324
Provider Name (Legal Business Name): PATHWAY TO SERENITY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 E TOLIVER ST
HOUSTON TX
77016-6241
US

IV. Provider business mailing address

4214 E TOLIVER ST
HOUSTON TX
77016-6241
US

V. Phone/Fax

Practice location:
  • Phone: 713-631-0366
  • Fax: 281-447-6071
Mailing address:
  • Phone: 713-631-0366
  • Fax: 281-447-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY VINCE OWENS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 713-631-0366