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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