Provider Demographics
NPI:1477155398
Name:INDEPENDENT PATHWAYS, LLC
Entity Type:Organization
Organization Name:INDEPENDENT PATHWAYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-871-8127
Mailing Address - Street 1:1616 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-2322
Mailing Address - Country:US
Mailing Address - Phone:330-871-8127
Mailing Address - Fax:330-871-8426
Practice Address - Street 1:1616 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:OH
Practice Address - Zip Code:44641-2322
Practice Address - Country:US
Practice Address - Phone:330-871-8127
Practice Address - Fax:330-871-8426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities