Provider Demographics
NPI:1912162017
Name:PATHWAYS HOUSELLC
Entity Type:Organization
Organization Name:PATHWAYS HOUSELLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAMONT
Authorized Official - Middle Name:ARNEZ
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-784-9885
Mailing Address - Street 1:5524 CREEKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1800
Mailing Address - Country:US
Mailing Address - Phone:817-468-6091
Mailing Address - Fax:817-468-6097
Practice Address - Street 1:5524 CREEKRIDGE DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1800
Practice Address - Country:US
Practice Address - Phone:817-468-6091
Practice Address - Fax:817-468-6097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102924310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility