Provider Demographics
NPI:1639620636
Name:PATHWAY HOMES OF FLORIDA, INC.
Entity Type:Organization
Organization Name:PATHWAY HOMES OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SYLISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERT-WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCSW, LSATP, MA
Authorized Official - Phone:703-876-0390
Mailing Address - Street 1:7751 KINGSPOINTE PKWY
Mailing Address - Street 2:SUITE 126
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-6500
Mailing Address - Country:US
Mailing Address - Phone:407-205-2266
Mailing Address - Fax:
Practice Address - Street 1:7751 KINGSPOINTE PKWY
Practice Address - Street 2:SUITE 126
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-6500
Practice Address - Country:US
Practice Address - Phone:407-205-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATHWAY HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management