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General NPI Number Information
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NPI Number | 1093166845
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Entity Type | Organization
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Legal Business Name | PATHWAY HOUSE, INC.
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 806 W 10TH ST
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City | JOHNSTON CITY
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State | IL
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Zip | 62951-1017
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Country | US
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Telephone | 618-983-8254
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Fax | 618-983-8254
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | JOHNSTON CITY
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State | IL
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Zip | 62951-0207
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Country | US
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Telephone | 618-983-8254
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Fax | 618-983-8254
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Authorized Official
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Title or Position | CO - DIRECTOR
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Name | NATHAN ING
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Credential |
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Telephone | 618-201-9993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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