Provider Demographics
NPI:1558727784
Name:PATHWAYS FAMILY SUPPORT SERVICES
Entity Type:Organization
Organization Name:PATHWAYS FAMILY SUPPORT SERVICES
Other - Org Name:BLACK BOYS OF DISTINCTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-978-7557
Mailing Address - Street 1:PO BOX 170066
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-0021
Mailing Address - Country:US
Mailing Address - Phone:864-595-0515
Mailing Address - Fax:864-587-6409
Practice Address - Street 1:150 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3983
Practice Address - Country:US
Practice Address - Phone:864-595-0515
Practice Address - Fax:864-587-6409
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISED LAND COMMUNITY DEVELOPMENT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health