Organization
PATHWAYS TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JOHNSON BS (SERVICE COORDINATOR,OWNER)
(208) 538-7754
Entity
Organization
Contact information
Practice address
197 N 4700 E, RIGBY, ID 83442-5912
(208) 538-7754
(208) 538-6042
Mailing address
197 N 4700 E, RIGBY, ID 83442-5912
(208) 538-7754
(208) 538-6042
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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