Provider Demographics
NPI:1710112479
Name:A PATHWAY COMMUNITY SUPPORT SERVIES
Entity Type:Organization
Organization Name:A PATHWAY COMMUNITY SUPPORT SERVIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:RICH
Authorized Official - Last Name:BLETHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-585-0079
Mailing Address - Street 1:2607 HOLLY HILL ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5176
Mailing Address - Country:US
Mailing Address - Phone:336-585-0079
Mailing Address - Fax:
Practice Address - Street 1:2607 HOLLY HILL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5176
Practice Address - Country:US
Practice Address - Phone:336-585-0079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health