MEDICARE: NEW PATHWAYS RECOVERY CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	PC10303	NC

General Provider Information

NPI Number	:	1134409428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PATHWAYS RECOVERY CENTER, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 15507
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28561-5507
Country	:	US
Telephone Number	:	252-723-0959
Fax Number	:	252-633-1008

Provider Business Practice Location Address
First Line	:	1900 US HIGHWAY 70 E STE C
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-6818
Country	:	US
Telephone Number	:	252-723-0959
Fax Number	:	252-633-1008

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT WEBSTER
Credential	:	M.S., NCC, LPC, CMAT
Telephone Number	:	252-723-0959

Provider Enumeration Date	:	08/18/2011
Last Update Date	:	08/18/2011

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