Provider Demographics
NPI:1235588450
Name:PATHWAYS TO INDEPENDENCE CENTRAL OH
Entity Type:Organization
Organization Name:PATHWAYS TO INDEPENDENCE CENTRAL OH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-378-2498
Mailing Address - Street 1:7020 HUNTLEY RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1050
Mailing Address - Country:US
Mailing Address - Phone:614-378-2498
Mailing Address - Fax:
Practice Address - Street 1:7020 HUNTLEY RD
Practice Address - Street 2:SUITE D
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1050
Practice Address - Country:US
Practice Address - Phone:614-378-2498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2569475251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2569475Medicaid