| Pathway House Rtc & Iop | |
|
712 Rencher St 316 West 7th Street Clovis NM 88101-6560 | |
| (505) 763-5003 | |
| (505) 762-2815 |
| Full Name | Pathway House Rtc & Iop |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children |
| Location | 712 Rencher St, Clovis, New Mexico |
| Authorized Official Name and Position | Eugene D Lovato (CEO/OWNER) |
| Authorized Official Contact | 5057626091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway House Rtc & Iop Po Box 582 712 Rencher Clovis NM 88102-0582 Ph: (505) 762-6091 | Pathway House Rtc & Iop 712 Rencher St 316 West 7th Street Clovis NM 88101-6560 Ph: (505) 763-5003 |
| NPI Number | 1326136532 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326136532 | NPI | - | NPPES |
| M1703 | Medicaid | NM | |
| NM600401 | Other | NM | VALUE OPTION ID # |
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