Provider Demographics
NPI:1942671748
Name:PATHWAY INTERNATIONAL INCORPORATED
Entity Type:Organization
Organization Name:PATHWAY INTERNATIONAL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HORNBACK
Authorized Official - Suffix:
Authorized Official - Credentials:BSEE, MBA
Authorized Official - Phone:317-432-3664
Mailing Address - Street 1:8928 FATHOM CRST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9571
Mailing Address - Country:US
Mailing Address - Phone:317-432-3664
Mailing Address - Fax:
Practice Address - Street 1:3905 VINCENNES RD STE 303
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3030
Practice Address - Country:US
Practice Address - Phone:317-432-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty