| Path For Change Llc | |
|
2502 E University Dr Ste 240 Phoenix AZ 85034-6956 | |
| (512) 679-3381 | |
| Not Available |
| Full Name | Path For Change Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2502 E University Dr Ste 240, Phoenix, Arizona |
| Authorized Official Name and Position | Claude Mujyanama (MEMBER) |
| Authorized Official Contact | 5126793381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Path For Change Llc 2502 E University Dr Ste 240 Phoenix AZ 85034-6956 Ph: (512) 679-3381 | Path For Change Llc 2502 E University Dr Ste 240 Phoenix AZ 85034-6956 Ph: (512) 679-3381 |
| NPI Number | 1609553080 |
|---|---|
| Provider Enumeration Date | 06/28/2023 |
| Last Update Date | 10/27/2023 |
| Certification Date | 10/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609553080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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