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PATHWAYS 1 SOBER LIVING NPI 1720659816


NPI Information

NPI: 1720659816
Provider Name: PATHWAYS 1 SOBER LIVING
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 05D2293049

Address:
1033 N SOLDANO AVE
AZUSA, CA
ZIP 91702
Phone: (626) 515-6424
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PATHWAYS 1 SOBER LIVING is a substance abuse rehabilitation facility in Azusa, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PATHWAYS 1 SOBER LIVING NPI is 1720659816. The provider is registered as an organization entity type.

The provider's business location address is:

1033 N SOLDANO AVE
AZUSA, CA
ZIP 91702-136
Phone: (626) 515-6424
Fax: (626) 515-8279

The provider's authorized official is Madonna Michelle Lecaine .
The authorized official title is Executive Assistant and has the following contact phone number (626) 412-6812.

The CLIA number assigned to this NPI record is 05D2293049 - other - residential treat facil with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/8/2021 and was last updated on 7/8/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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