MEDICARE: PATHWAY SUPPORT AND REHABILITATION SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	251E00000X	Home Health Agency
3	251S00000X	Community/Behavioral Health Agency
4	253Z00000X	In Home Supportive Care Agency
5	261QM0850X	Adult Mental Health Clinic/Center
6	261QM0855X	Adolescent and Children Mental Health Clinic/Center
7	261QR0400X	Rehabilitation Clinic/Center
8	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
9	261QR0800X	Recovery Care Clinic/Center
10	311ZA0620X	Adult Care Home Facility
11	320800000X	Mental Illness Community Based Residential Treatment Facility
12	343900000X	Non-emergency Medical Transport (VAN)
13	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1487512802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAY SUPPORT AND REHABILITATION SERVICES, LLC

Provider Business Mailing Address
First Line	:	11133 SHADY TRL
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-4617
Country	:	US
Telephone Number	:	214-494-9605
Fax Number	:

Provider Business Practice Location Address
First Line	:	11133 SHADY TRL
Second Line	:	PMB 153
City	:	DALLAS
State	:	TX
Zip	:	75229-4617
Country	:	US
Telephone Number	:	214-494-9605
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CHRISTOPHER THARPE
Credential	:
Telephone Number	:	870-500-4799

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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