Provider Demographics
NPI:1790013241
Name:PATHWAY FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:PATHWAY FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLD HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-208-1826
Mailing Address - Street 1:PO BOX 2224
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2224
Mailing Address - Country:US
Mailing Address - Phone:620-343-6111
Mailing Address - Fax:785-232-2833
Practice Address - Street 1:4101 SW MARTIN DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-1217
Practice Address - Country:US
Practice Address - Phone:620-343-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003907770001Medicaid
KS30003907770002Medicaid
TXPENDINGMedicaid
KS30003907770003Medicaid