MEDICARE: PALMETTO PATHWAY SUPPORT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1346177318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO PATHWAY SUPPORT LLC

Provider Business Mailing Address
First Line	:	50 PROPRIETORS LN
Second Line	:
City	:	TORRINGTON
State	:	CT
Zip	:	06790-8602
Country	:	US
Telephone Number	:	860-578-4768
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 RIVERS AVE STE 100
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-4809
Country	:	US
Telephone Number	:	860-578-4768
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ALEXANDER LENARCHYK
Credential	:
Telephone Number	:	860-578-4768

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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