Organization
PATHWAY LIVING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA MARY PETERSON LBSW, MBA (EXECUTIVE DIRECTOR)
(563) 242-3687
Entity
Organization
Contact information
Practice address
562 2ND AVE S, CLINTON, IA 52732
(563) 242-3687
(563) 242-9319
Mailing address
P.O. BOX 1896, CLINTON, IA 52733-1896
(563) 242-3687
(563) 242-9319
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231548
—
IA
05
—
0423400
—
IA
Enumeration date
04/30/2007
Last updated
08/22/2020
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