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Organization

PATHWAYS BEHAVIORAL HEALTH CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDY FULLER (BILLING CLERK)
(660) 890-8076
Entity
Organization

Contact information

Practice address
1010 REMINGTON PLZ, RAYMORE, MO 64083-8640
(816) 318-4430
Mailing address
211 J ST APT C1, CREIGHTON, MO 64739-9771
(816) 372-2652

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2000165271
MO
302R00000X
Health Maintenance Organization
2000165271
MO

Other

Enumeration date
08/21/2014
Last updated
08/21/2014
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