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General NPI Number Information
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NPI Number | 1184903429
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO SUCCESS, LLC
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 407 E NINE MILE RD
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City | HIGHLAND SPRINGS
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State | VA
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Zip | 23075-1857
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Country | US
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Telephone | 804-737-1122
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Fax | 804-737-1120
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Provider Business Mailing Address
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Address Line | 407 E NINE MILE RD
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City | HIGHLAND SPRINGS
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State | VA
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Zip | 23075-1857
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Country | US
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Telephone | 804-737-1122
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Fax | 804-737-1120
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMAAL ALLAH
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Credential |
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Telephone | 804-737-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 1434-05-001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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