MEDICARE: PATHWAYS HEALTH SERVICES

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

General Provider Information

NPI Number	:	1164020947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS HEALTH SERVICES

Provider Business Mailing Address
First Line	:	5813 MICHAEL DEAN ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-4422
Country	:	US
Telephone Number	:	702-666-3492
Fax Number	:

Provider Business Practice Location Address
First Line	:	5813 MICHAEL DEAN ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-4422
Country	:	US
Telephone Number	:	702-666-3492
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALTRACIA V. DORSEY
Credential	:
Telephone Number	:	702-666-3492

Provider Enumeration Date	:	10/13/2020
Last Update Date	:	10/13/2020

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Directions to “PATHWAYS HEALTH SERVICES ” Practice Location

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