Organization
PATHWAY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALESHA B BOOTH (CHIEF FINANCIAL OFFICER)
(334) 464-3668
Entity
Organization
Contact information
Practice address
39 PRIVATE ROAD 1201, NEW BROCKTON, AL 36351-7910
(334) 894-5591
(334) 894-5264
Mailing address
PO BOX 311206, ENTERPRISE, AL 36331-1206
(334) 464-3668
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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