OrganizationActive
Eternal Pathway LLC
NPI 1003483447 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Phoenix, AZ
Provider details
- NPI number
- 1003483447
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Linette Wilson, Owner/ Manager(305) 731-6917
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11225 N 28th Dr Ste D104
Phoenix, AZ 85029-5609
Phone: (602) 607-5422
Street-level locationGet directions
Mailing address
11225 N 28th Dr Ste D104
Phoenix, AZ 85029-5609
Registry dates
- Enumerated
- 2021-06-04
- Last updated
- 2021-06-04
- Certified
- 2021-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.