Provider Demographics
NPI:1568270197
Name:SAFE PATHWAY MANAGEMENT, LLC
Entity type:Organization
Organization Name:SAFE PATHWAY MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGED
Authorized Official - Prefix:
Authorized Official - First Name:KIAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-809-2496
Mailing Address - Street 1:4422 N RAVENSWOOD AVE # 1033
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5803
Mailing Address - Country:US
Mailing Address - Phone:708-809-2496
Mailing Address - Fax:708-392-2325
Practice Address - Street 1:4422 N RAVENSWOOD AVE # 1033
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5803
Practice Address - Country:US
Practice Address - Phone:708-809-2496
Practice Address - Fax:708-392-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-30
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)