Provider Demographics
NPI:1720345556
Name:PATHWAY CARING FOR CHILDREN
Entity Type:Organization
Organization Name:PATHWAY CARING FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:UMBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-493-0083
Mailing Address - Street 1:4895 DRESSLER RD NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2543
Mailing Address - Country:US
Mailing Address - Phone:330-493-0083
Mailing Address - Fax:330-493-3689
Practice Address - Street 1:4895 DRESSLER RD NW
Practice Address - Street 2:SUITE A
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2543
Practice Address - Country:US
Practice Address - Phone:330-493-0083
Practice Address - Fax:330-493-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
OH0547251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH215-01OtherJOB AND FAMILY SERVICES
OH12218OtherMEDICAID UPI
OH2864191Medicaid
OH547OtherOHIO DEPT. OF MENTAL HEALTH CERTIFICATION NUMBER