Healthcare Provider Details

I. General information

NPI: 1346177318
Provider Name (Legal Business Name): PALMETTO PATHWAY SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 RIVERS AVE STE 100
NORTH CHARLESTON SC
29406-4809
US

IV. Provider business mailing address

50 PROPRIETORS LN
TORRINGTON CT
06790-8602
US

V. Phone/Fax

Practice location:
  • Phone: 860-578-4768
  • Fax:
Mailing address:
  • Phone: 860-578-4768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER LENARCHYK
Title or Position: COO
Credential:
Phone: 860-578-4768