Provider Demographics
NPI:1831067347
Name:DANDELIONS PATHWAYS LLC
Entity type:Organization
Organization Name:DANDELIONS PATHWAYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHD DZAIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHD DAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-353-2368
Mailing Address - Street 1:5706 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-8422
Mailing Address - Country:US
Mailing Address - Phone:479-353-2368
Mailing Address - Fax:949-561-4703
Practice Address - Street 1:5706 THOMAS RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-8422
Practice Address - Country:US
Practice Address - Phone:479-353-2368
Practice Address - Fax:949-561-4703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty