Provider Demographics
NPI:1285734277
Name:PATHWAY CARING FOR CHILDEN
Entity type:Organization
Organization Name:PATHWAY CARING FOR CHILDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MSSA, LISW
Authorized Official - Phone:330-493-0083
Mailing Address - Street 1:6370 WISE AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7350
Mailing Address - Country:US
Mailing Address - Phone:330-493-0083
Mailing Address - Fax:330-493-3689
Practice Address - Street 1:6370 WISE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7350
Practice Address - Country:US
Practice Address - Phone:330-493-0083
Practice Address - Fax:330-493-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
OH547261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH215-01OtherJOB AND FAMILY SERVICES
OH547Medicaid
OH547Medicaid