Organization
A NEW PATHWAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATIELA STUCKES (CEO)
(980) 355-3737
Entity
Organization
Contact information
Practice address
1935 J N PEASE PL STE 102, CHARLOTTE, NC 28262-4541
(704) 616-0694
(980) 422-0336
Mailing address
1935 J N PEASE PL STE 102, CHARLOTTE, NC 28262-4541
(704) 616-0694
(980) 422-0336
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
04/01/2019
Last updated
09/18/2024
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