Provider Demographics
NPI:1467775668
Name:TRANSITION PATHWAYS,INC
Entity Type:Organization
Organization Name:TRANSITION PATHWAYS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-666-9921
Mailing Address - Street 1:3355 EAGLE PARK DR NE
Mailing Address - Street 2:STE 107
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-7004
Mailing Address - Country:US
Mailing Address - Phone:616-666-9921
Mailing Address - Fax:866-222-8422
Practice Address - Street 1:3355 EAGLE PARK DR NE
Practice Address - Street 2:STE 107
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7004
Practice Address - Country:US
Practice Address - Phone:616-666-9921
Practice Address - Fax:866-222-8422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010978061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209511Medicare PIN