Provider Demographics
NPI:1710126586
Name:PATHWAYS BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:PATHWAYS BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:319-235-6571
Mailing Address - Street 1:315 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLISON
Mailing Address - State:IA
Mailing Address - Zip Code:50602-7708
Mailing Address - Country:US
Mailing Address - Phone:319-267-2629
Mailing Address - Fax:319-267-2629
Practice Address - Street 1:315 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLISON
Practice Address - State:IA
Practice Address - Zip Code:50602-7708
Practice Address - Country:US
Practice Address - Phone:319-267-2629
Practice Address - Fax:319-267-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
324500000X
IA12363245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children