Healthcare Provider Details

I. General information

NPI: 1902721285
Provider Name (Legal Business Name): CLEAR PATH SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 HUBERT ST
RALEIGH NC
27603-2301
US

IV. Provider business mailing address

28 JEAN LO WAY
YORK PA
17406-6704
US

V. Phone/Fax

Practice location:
  • Phone: 800-619-8164
  • Fax:
Mailing address:
  • Phone: 240-849-0691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LESLIE MCINTOSH JR.
Title or Position: MANAGEMENT MEMBER
Credential:
Phone: 240-849-0691