Provider Demographics
NPI:1871391987
Name:PATH PSYCHIATRIC-MENTAL HEALTH, LLC.
Entity type:Organization
Organization Name:PATH PSYCHIATRIC-MENTAL HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:501-206-4466
Mailing Address - Street 1:718 SAGEWOOD CV
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-6632
Mailing Address - Country:US
Mailing Address - Phone:501-206-4466
Mailing Address - Fax:
Practice Address - Street 1:109 S 3RD ST
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-3805
Practice Address - Country:US
Practice Address - Phone:501-206-4466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)