Provider Demographics
NPI:1902634793
Name:SUPPORTIVE PATHWAYS
Entity type:Organization
Organization Name:SUPPORTIVE PATHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-572-3917
Mailing Address - Street 1:2077 WATER CREST LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3338
Mailing Address - Country:US
Mailing Address - Phone:614-572-3917
Mailing Address - Fax:
Practice Address - Street 1:2077 WATER CREST LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3338
Practice Address - Country:US
Practice Address - Phone:614-572-3917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health