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Organization

PATH 2 POTENTIAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON LANTIER BCBA (CEO)
(917) 270-6865
Entity
Organization

Contact information

Practice address
5812 QUEENS BLVD, 5O, WOODSIDE, NY 11377-7765
(917) 270-6865
Mailing address
5812 QUEENS BLVD, 5O, WOODSIDE, NY 11377-7765
(917) 270-6865

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
000710
NY

Other

Enumeration date
06/14/2016
Last updated
06/14/2016
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