Provider Demographics
NPI:1780789115
Name:PATHWAYS OF TENNESSEE, INC.
Entity type:Organization
Organization Name:PATHWAYS OF TENNESSEE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-541-5000
Mailing Address - Street 1:238 SUMMAR DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3906
Mailing Address - Country:US
Mailing Address - Phone:731-541-8200
Mailing Address - Fax:731-541-8327
Practice Address - Street 1:238 SUMMAR DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3906
Practice Address - Country:US
Practice Address - Phone:731-935-8200
Practice Address - Fax:731-935-8327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNL000000034505OtherTN DEPT OF MHSAS
TN249OtherDOH LICENSE NUMBER
TN444010Medicare Oscar/Certification