1235733734 NPI number — DEVELOPING PATHWAYS LLC

Table of content: (NPI 1235733734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235733734 NPI number — DEVELOPING PATHWAYS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEVELOPING PATHWAYS LLC
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:
1235733734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1754 HILLVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44112-1226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-856-0068
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9328 ASHCROFT LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TWINSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44087-2536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-258-5197
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/24/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
DONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER, CEO
Authorized Official Telephone Number:
216-856-0068

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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