ILLUMINATED PATHWAY LLC NPI 1275122442

NPI Information

NPI: 1275122442
Provider Name: ILLUMINATED PATHWAY LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address: 17427 W WANDERING CREEK RD
GOODYEAR, AZ
ZIP 85338
Phone: (253) 208-0756

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NPI Details

ILLUMINATED PATHWAY LLC is a community behavioral health in Goodyear, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. ILLUMINATED PATHWAY LLC NPI is 1275122442. The provider is registered as an organization entity type.

The provider's business location address is:

17427 W WANDERING CREEK RD
GOODYEAR, AZ
ZIP 85338-735
Phone: (253) 208-0756

The provider's authorized official is Katherine Michelle Jackson .
The authorized official title is Director and has the following contact phone number (253) 208-0756.

The enumeration date for this NPI number is 1/13/2021 and was last updated on 7/11/2024.

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	Primary
1	174200000X	Meals	No
2	177F00000X	Lodging	No
3	251B00000X	Case Management	No
4	251C00000X	Day Training, Developmentally Disabled Services	No
5	251K00000X	Public Health or Welfare	No
6	251S00000X	Community/Behavioral Health	Yes
7	253J00000X	Foster Care Agency	No
8	253Z00000X	In Home Supportive Care	No

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: 11/21/2025

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