Organization
PATHWAY TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STELLA K FOWLER (ADMINISTRATOR)
(336) 229-2008
Entity
Organization
Contact information
Practice address
112 STAGG ST, BURLINGTON, NC 27217-2654
(336) 229-2008
(336) 229-2008
Mailing address
2445 HILLFORD DR, BURLINGTON, NC 27217-3173
(336) 229-5580
(336) 229-2008
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
FCL-001-028
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805484
—
NC
Enumeration date
03/26/2007
Last updated
08/04/2009
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