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General NPI Number Information
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NPI Number | 1235792706
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Entity Type | Organization
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Legal Business Name | PATHWAY TO PURPOSE EARLY LEARNING CENTER LLC
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 1536 SAINT CLAIR AVE NE
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City | CLEVELAND
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State | OH
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Zip | 44114-2004
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Country | US
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Telephone | 216-220-7250
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Fax |
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Provider Business Mailing Address
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Address Line | 3703 W 135TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-3323
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Country | US
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Telephone | 216-990-4569
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. ASHAY MONAE BUCKNER
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Credential | LISW
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Telephone | 216-990-4569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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