Organization
ABILITY PATHWAYS INC
Active
Other names
Crockett Division
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE CLARKE (PRESIDENT)
(909) 240-7680
Entity
Organization
Contact information
Practice address
10528 CROCKETT ST, SUN VALLEY, CA 91352-2208
(818) 252-7143
(909) 981-0296
Mailing address
1042 N MOUNTAIN AVE B-447, UPLAND, CA 91786-3695
(909) 982-2991
(909) 981-0296
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
960001328
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC60981F
—
CA
Enumeration date
03/01/2007
Last updated
11/09/2017
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