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General NPI Number Information
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NPI Number | 1497213581
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Entity Type | Organization
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Legal Business Name | PATHWAYS INC
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 2670 CRAIN HWY STE 300
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City | WALDORF
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State | MD
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Zip | 20601-2817
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Country | US
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Telephone | 301-373-3065
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Fax | 240-419-3201
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | HOLLYWOOD
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State | MD
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Zip | 20636-0129
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Country | US
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Telephone | 301-373-3065
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Fax | 240-419-3201
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMANDA M MULLINS
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Credential |
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Telephone | 301-373-3065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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