| Path Recovery Llc | |
|
1994 Gallatin Pike N Ste 100 Madison TN 37115-2095 | |
| (615) 766-8013 | |
| (615) 208-1219 |
| Full Name | Path Recovery Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1994 Gallatin Pike N Ste 100, Madison, Tennessee |
| Authorized Official Name and Position | Kenia Kane (OPERATIONS MANAGER) |
| Authorized Official Contact | 5618601478 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Path Recovery Llc 1994 Gallatin Pike N Madison TN 37115-2026 Ph: () - | Path Recovery Llc 1994 Gallatin Pike N Ste 100 Madison TN 37115-2095 Ph: (615) 766-8013 |
| NPI Number | 1922833565 |
|---|---|
| Provider Enumeration Date | 09/04/2024 |
| Last Update Date | 02/28/2025 |
| Certification Date | 02/28/2025 |
| Medicare PECOS PAC ID | 6305368309 |
|---|---|
| Medicare Enrollment ID | O20250319002758 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922833565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
| Provider Name | Millard D Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952389173 PECOS PAC ID: 5395710495 Enrollment ID: I20040901000365 |
| Provider Name | Nathan A De Graaf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770640757 PECOS PAC ID: 4587695580 Enrollment ID: I20050830000398 |
| Provider Name | Julie D Eberwein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295972313 PECOS PAC ID: 3173042025 Enrollment ID: I20250523001794 |
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