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General NPI Number Information
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NPI Number | 1245533942
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Entity Type | Organization
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Legal Business Name | PATHWAYS BEHAVIORAL GROUP
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Dates
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Enumeration Date | 12/18/2010
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 2881 E OAKLAND PARK BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1813
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Country | US
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Telephone | 786-468-3296
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Fax | 954-315-1763
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Provider Business Mailing Address
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Address Line | 2881 E OAKLAND PARK BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1813
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Country | US
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Telephone | 786-468-3296
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Fax | 954-315-1763
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Authorized Official
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Title or Position | DIRECTOR
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Name | LORI B BRYANT
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Credential |
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Telephone | 786-468-3296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 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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