Healthcare Provider Details

I. General information

NPI: 1609742626
Provider Name (Legal Business Name): SLC PATHWAYS BEHAVIORAL HEALTH & YOUTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/25/2025
Certification Date: 10/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9309 GETTYSBURG DR
TWINSBURG OH
44087
US

IV. Provider business mailing address

9309 GETTYSBURG DR
TWINSBURG OH
44087-1511
US

V. Phone/Fax

Practice location:
  • Phone: 216-256-4613
  • Fax:
Mailing address:
  • Phone: 216-256-4613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHANNON L CONWAY JR.
Title or Position: CEO
Credential: MBA
Phone: 216-256-4613