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General NPI Number Information
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NPI Number | 1538874268
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO TRUE FREEDOM FOUNDATION INC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 969 ARCADE ST
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City | SAINT PAUL
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State | MN
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Zip | 55106-3229
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Country | US
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Telephone | 612-567-7266
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Fax |
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Provider Business Mailing Address
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Address Line | 7964 BROOKLYN BLVD STE 207
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City | BROOKLYN PARK
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State | MN
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Zip | 55445-2722
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Country | US
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Telephone | 612-990-8862
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DEJA M ALLEN
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Credential |
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Telephone | 612-990-8862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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