Eternal Pathway LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ETERNAL PATHWAY LLC

Practice address

11225 N 28TH Dr Ste D104
Phoenix, AZ 85029-5609

Phone

(602) 607-5422

NPI assigned

Jun 4, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Linette WilsonNPI 1033701909

Title

Owner/ Manager

Phone

(305) 731-6917

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linette Wilson

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
  • NPI 1033701909
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1003483447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11225 N 28TH DR STE D104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295609",
            "telephone_number": "602-607-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11225 N 28TH DR STE D104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295609",
            "telephone_number": "602-607-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNAL PATHWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LINETTE",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "305-731-6917"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@eternalpathwayllc.com",
            "affiliation": "N",
            "endpointDescription": "Therapy Notes",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11225 N 28th Dr Ste D104",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850295609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rose Esty
• Kristi Etchechury, COTA/L
• Jessica Etchells, PA-C
• Eternal Hope Therapy Services LLC
• Eternal Love Hospice LLC
• Eternity Home Health Care LLC
• Eternity Hospice and Palliative Care, PLLC
• Eternity Services LLC
• Cristina Rose Etienne, P.A.
• Gregory C Etienne, PA

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.