Provider Demographics
NPI:1073016440
Name:STAR PATHWAYS
Entity Type:Organization
Organization Name:STAR PATHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSEY-BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:866-975-7469
Mailing Address - Street 1:70 BIRCH ALY STE 240
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-1477
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 BIRCH ALY STE 240
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-1477
Practice Address - Country:US
Practice Address - Phone:866-975-7469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAR PATHWAYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-13
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)