Provider Demographics
NPI:1467781013
Name:PATHWAYS COMMUNITY SERIVCES LLC
Entity Type:Organization
Organization Name:PATHWAYS COMMUNITY SERIVCES LLC
Other - Org Name:CYS PATHWAYS COMMUNITY SERVICES GARDEN GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF STATE OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CBCS
Authorized Official - Phone:657-465-9497
Mailing Address - Street 1:8337 TELEGRAPH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-4957
Mailing Address - Country:US
Mailing Address - Phone:562-467-5440
Mailing Address - Fax:562-467-5553
Practice Address - Street 1:12966 EUCLID ST
Practice Address - Street 2:200, 220 AND 280
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5200
Practice Address - Country:US
Practice Address - Phone:714-823-4770
Practice Address - Fax:714-823-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALEGAL ENTITY # 00801OtherMEDICAL PROVIDER NUMBER 30EV