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General NPI Number Information
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NPI Number | 1548074560
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Entity Type | Organization
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Legal Business Name | PAVING THE WAY TRANSITIONAL HOUSING INC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 4710 E 30TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-3109
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Country | US
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Telephone | 317-223-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 N LESLEY AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-5046
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Country | US
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Telephone | 317-223-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARMEN KENNEDY
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Credential |
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Telephone | 317-223-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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