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General NPI Number Information
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NPI Number | 1861054751
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Entity Type | Organization
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Legal Business Name | PRODUCTIVE PATHWAYS TRANSITIONAL SERVICES, INC
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 835 SYCAMORE ST # H8
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City | TITUSVILLE
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State | FL
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Zip | 32780-7700
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Country | US
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Telephone | 321-363-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 835 SYCAMORE ST # H8
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City | TITUSVILLE
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State | FL
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Zip | 32780-7700
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Country | US
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Telephone | 321-363-9333
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Fax |
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | DOTRALEE MCNEAL
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Credential | CBHCM102301
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Telephone | 321-363-9333
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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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