# PATHWAYS SUPPORTED LIVING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932922853
- **Authorized official:** MRS. DEANNA M CRONK RN (PROGRAM DIRECTOR/ OWNER)
- **Authorized official phone:** (616) 540-3597

## Contact information

- **Practice address:** 4575 ALDUN RIDGE AVE NW \# 110A, COMSTOCK PARK, MI 49321-9012
- **Practice address phone:** (616) 540-3597
- **Practice address fax:** (616) 449-1002
- **Mailing address:** 6250 ROYALTON DR SE, CALEDONIA, MI 49316-8067
- **Mailing address phone:** (616) 540-3597

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC1500X | Community Health Registered Nurse | — | NULL | Yes |
| 163WC1500X | Community Health Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2024
- **Last updated:** 11/07/2024