Provider Demographics
NPI:1093164741
Name:ROUSES-PATHS
Entity Type:Organization
Organization Name:ROUSES-PATHS
Other - Org Name:PATHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-339-8404
Mailing Address - Street 1:140 E MURPHY ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NC
Mailing Address - Zip Code:27025-1920
Mailing Address - Country:US
Mailing Address - Phone:336-427-2562
Mailing Address - Fax:336-427-2978
Practice Address - Street 1:140 E MURPHY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1920
Practice Address - Country:US
Practice Address - Phone:336-427-2562
Practice Address - Fax:336-427-2978
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROUSES GROUP HOME II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services