Provider Demographics
NPI:1902062565
Name:PATHWAYS-HOMES FOR EXCEPTIONAL PERSONS
Entity Type:Organization
Organization Name:PATHWAYS-HOMES FOR EXCEPTIONAL PERSONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:EVON
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-843-7388
Mailing Address - Street 1:4652 MEDALTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3527
Mailing Address - Country:US
Mailing Address - Phone:314-843-7388
Mailing Address - Fax:314-849-6607
Practice Address - Street 1:4652 MEDALTON WAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-3527
Practice Address - Country:US
Practice Address - Phone:314-843-7388
Practice Address - Fax:314-849-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services