1487512802 NPI number — PATHWAY SUPPORT AND REHABILITATION SERVICES, LLC

NPI Number: 1487512802
Health Care Provider/Practitioner: PATHWAY SUPPORT AND REHABILITATION SERVICES, LLC

NPI Number : 1487512802 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487512802",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PATHWAY SUPPORT AND REHABILITATION SERVICES, LLC",
    "LastName": null,
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    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "11133 SHADY TRL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75229-4617",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-494-9605",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11133 SHADY TRL",
    "SecondLinePracticeLocationAddress": "PMB 153",
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75229-4617",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-494-9605",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/14/2026",
    "LastUpdateDate": "01/14/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THARPE",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "870-500-4799",
    "Taxonomies": {
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          "TaxonomyCode": "261QR0400X",
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        },
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          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
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    "HealthcareProviderTaxonomyGroups": null
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}