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General NPI Number Information
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NPI Number | 1063301471
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Entity Type | Organization
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Legal Business Name | PATH 2 PURPOSE LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 03/08/2026
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Provider Practice Location Address
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Address Line | 300 MARKET ST STE 104
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City | DENTON
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State | MD
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Zip | 21629-1051
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Country | US
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Telephone | 443-286-9535
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Fax |
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Provider Business Mailing Address
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Address Line | 3114 W NORTH AVE
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City | BALTIMORE
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State | MD
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Zip | 21216-3012
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Country | US
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Telephone | 443-286-9535
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NICKIA WILLIAMS
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Credential | BS
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Telephone | 443-286-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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