Provider Demographics
NPI:1598510349
Name:PATHWAY, INC.
Entity type:Organization
Organization Name:PATHWAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALESHA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-464-3668
Mailing Address - Street 1:PO BOX 311206
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36331-1206
Mailing Address - Country:US
Mailing Address - Phone:334-464-3668
Mailing Address - Fax:
Practice Address - Street 1:39 PRIVATE ROAD 1201
Practice Address - Street 2:
Practice Address - City:NEW BROCKTON
Practice Address - State:AL
Practice Address - Zip Code:36351-7910
Practice Address - Country:US
Practice Address - Phone:334-894-5591
Practice Address - Fax:334-894-5264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children