NPI 1306662903

Pathway Camp Mitnick LLC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Jasper, AL

Practice location

Address: 4436 Calumet Loop, Jasper, AL 35501-7845
Phone: (334) 464-3668
Mailing address: PO Box 311206, Enterprise, AL 36331-1206

Authorised official

Name: Alesha Booth
Title: Chief Financial Officer
Phone: (334) 464-3668

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1306662903
Entity type: Organization
NPI issued: 27 Nov 2024
Record last updated: 27 Nov 2024

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.