Organization
PATHWAY TO RECOVERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS L MCCOLGIN LCDC (CEO/PRESIDENT)
(409) 933-4366
Entity
Organization
Contact information
Practice address
2119 OAK ST, LA MARQUE, TX 77568-4246
(409) 933-4366
(409) 933-4367
Mailing address
2119 OAK ST, LAMARQUE, TX 77568-4246
(409) 933-4366
(409) 933-4367
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1904-A
TX
324500000X
Substance Abuse Rehabilitation Facility
Primary
1904-A
TX
324500000X
Substance Abuse Rehabilitation Facility
1904A
TX
324500000X
Substance Abuse Rehabilitation Facility
1904B
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265402
COMP PSYCH PROVIDER #
TX
01
—
556366
VALUE OPTIONS PROVIDER #
TX
01
—
HH5101
BCBS PROVIDER NUMBER
TX
Enumeration date
08/15/2006
Last updated
03/10/2010
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