Provider Demographics
NPI:1942254578
Name:PATHWAYS PSYCHIATRIC HOSPITAL INC
Entity Type:Organization
Organization Name:PATHWAYS PSYCHIATRIC HOSPITAL INC
Other - Org Name:ROYAL OAKS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NADLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:660-647-9921
Mailing Address - Street 1:307 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:MO
Mailing Address - Zip Code:65360-1449
Mailing Address - Country:US
Mailing Address - Phone:660-647-9921
Mailing Address - Fax:660-647-3617
Practice Address - Street 1:307 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:MO
Practice Address - Zip Code:65360-1449
Practice Address - Country:US
Practice Address - Phone:660-647-9921
Practice Address - Fax:660-647-3617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO488.1283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR640000Medicare PIN