1992729651 NPI number — PATHWAYS YOUTH & FAMILY SERVICES, INC.

Table of content: (NPI 1992729651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992729651 NPI number — PATHWAYS YOUTH & FAMILY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS YOUTH & FAMILY SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992729651
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 SIDNEY BAKER ST S STE 435
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KERRVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78028-2105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-515-4343
Provider Business Mailing Address Fax Number:
830-315-2274

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 SIDNEY BAKER ST S STE 435
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERRVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78028-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-515-4343
Provider Business Practice Location Address Fax Number:
830-315-2274
Provider Enumeration Date:
07/26/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GALVAN
Authorized Official First Name:
ESMERALDA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
HR ASSISTANT
Authorized Official Telephone Number:
830-865-2390

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  1218599 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 300114101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0046MR . This is a "BCBS GROUP ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 079538701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".