Provider Demographics
NPI:1043083942
Name:PATHWAYS TO WELLNESS LLC
Entity type:Organization
Organization Name:PATHWAYS TO WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PEARSON
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:901-870-0258
Mailing Address - Street 1:65 GERMANTOWN CT
Mailing Address - Street 2:207
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4258
Mailing Address - Country:US
Mailing Address - Phone:901-878-3332
Mailing Address - Fax:901-350-7790
Practice Address - Street 1:65 GERMANTOWN CT, SUITE 207
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4258
Practice Address - Country:US
Practice Address - Phone:901-878-3332
Practice Address - Fax:901-350-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty