| Pathways For Enhanced Living, Llc | |
|
169 Dayton St Ridgewood NJ 07450-4407 | |
| (201) 445-3307 | |
| Not Available |
| Full Name | Pathways For Enhanced Living, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 169 Dayton St, Ridgewood, New Jersey |
| Authorized Official Name and Position | Marylynn R. Wiseman (PRESIDENT) |
| Authorized Official Contact | 2014453307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathways For Enhanced Living, Llc 169 Dayton St Ridgewood NJ 07450-4407 Ph: (201) 445-3307 | Pathways For Enhanced Living, Llc 169 Dayton St Ridgewood NJ 07450-4407 Ph: (201) 445-3307 |
| NPI Number | 1154443588 |
|---|---|
| Provider Enumeration Date | 04/05/2007 |
| Last Update Date | 07/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154443588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC04507100 (New Jersey) | Primary |
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