Organization
DESTINED PATH COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROBERT TUCKER LCAS (CFO)
(252) 864-9334
Entity
Organization
Contact information
Practice address
201 TYSON ST, GREENVILLE, NC 27834-1847
(252) 864-9334
(252) 304-3945
Mailing address
PO BOX 1195, BETHEL, NC 27812-1195
(252) 864-9334
(252) 304-3945
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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