Organization
THE PATHWAY AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANAYSA GREEN REGISTERED NURSE (CEO)
(706) 373-2908
Entity
Organization
Contact information
Practice address
1378 LANEY WALKER BLVD STE 103, AUGUSTA, GA 30901-2763
(706) 373-2908
Mailing address
1378 LANEY WALKER BLVD STE 103, AUGUSTA, GA 30901-2763
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
RN211924
GA
376K00000X
Nurse's Aide
Primary
RN211924
GU
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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