NPI 1003483447
Eternal Pathway LLC
Practice location
- Address
- 11225 N 28th Dr STE D104, Phoenix, AZ 85029-5609
- Phone
- (602) 607-5422
Authorised official
- Name
- Linette Wilson
- Title
- Owner/ Manager
- Phone
- (305) 731-6917
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1003483447
- Entity type
- Organization
- NPI issued
- 4 Jun 2021
- Record last updated
- 4 Jun 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.