Provider Demographics
NPI:1689756140
Name:PATHWAY HOMES, INC.
Entity Type:Organization
Organization Name:PATHWAY HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERT-WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-876-0390
Mailing Address - Street 1:8411 ARLINGTON BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4601
Mailing Address - Country:US
Mailing Address - Phone:703-876-0390
Mailing Address - Fax:
Practice Address - Street 1:8411 ARLINGTON BLVD STE 340
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4601
Practice Address - Country:US
Practice Address - Phone:703-876-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA121-03-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004944232Medicaid