Provider Demographics
NPI:1639683360
Name:CLEAR PATHWAYS FOR INDEPENDENCE LLC
Entity Type:Organization
Organization Name:CLEAR PATHWAYS FOR INDEPENDENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELLAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-994-1113
Mailing Address - Street 1:3056 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-2539
Mailing Address - Country:US
Mailing Address - Phone:904-994-1113
Mailing Address - Fax:
Practice Address - Street 1:7724 LYNCHBURG CT W # NA
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-0928
Practice Address - Country:US
Practice Address - Phone:904-994-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
FL142571496261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142571496Medicaid