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Organization
CONNIE MAE
Active
Organization
CONNIE MAE
Active
Other names
Ability Pathways Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE R CLARKE (PRESIDENT)
(909) 240-7680
Entity
Organization
Contact information
Practice address
1890 W. ARROW ROUTE, UPLAND, CA 91786
(909) 240-7680
(909) 982-2991
Mailing address
1042 N. MOUNTAIN AVE, B-447, UPLAND, CA 91786
(909) 240-7680
(909) 982-2991
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
PENDING
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
08/29/2008
Last updated
08/29/2008
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