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General NPI Number Information
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NPI Number | 1598602336
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Entity Type | Organization
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Legal Business Name | PERSISTENT YOUTH PATHWAYS INC
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 31586 TYME CT
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City | MENIFEE
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State | CA
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Zip | 92584-3838
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Country | US
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Telephone | 818-860-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 31586 TYME CT
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City | MENIFEE
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State | CA
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Zip | 92584-3838
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Country | US
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Telephone | 818-860-9779
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARQUITA BERRY
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Credential | BERRY
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Telephone | 818-860-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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