MEDICARE: CAREER PATHWAYS

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1538649421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREER PATHWAYS

Provider Business Mailing Address
First Line	:	1355 PIERCE BUTLER RTE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1359
Country	:	US
Telephone Number	:	651-400-1781
Fax Number	:	651-400-1782

Provider Business Practice Location Address
First Line	:	1355 PIERCE BUTLER RTE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1359
Country	:	US
Telephone Number	:	651-400-1781
Fax Number	:	651-400-1782

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	KATIE ROSS
Credential	:
Telephone Number	:	651-400-1781

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	08/20/2018

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Directions to “CAREER PATHWAYS ” Practice Location

Language	Start Address	Practice Location

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