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General NPI Number Information
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NPI Number | 1912862020
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Entity Type | Organization
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Legal Business Name | PATHWAY TO PROMISE LLC
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Dates
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Enumeration Date | 12/20/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 10401 LANDON ST
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City | CHARLOTTE
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State | NC
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Zip | 28215-9691
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Country | US
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Telephone | 347-693-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 3611 ARKLOW RD
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City | CHARLOTTE
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State | NC
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Zip | 28269-6748
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Country | US
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Telephone | 347-693-6691
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Fax | 347-693-6691
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Authorized Official
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Title or Position | OWNER
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Name | MICHON FARRER
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Credential |
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Telephone | 347-693-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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