NPIMap

Organization Active NPI

Pathways Youth Services, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Scottsburg, VA
National Provider Identifier
1164762563
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
CRF-279 Issued in VA
Legal business name
PATHWAYS YOUTH SERVICES, LLC
Practice address
1099 Bagwell Dr
Scottsburg, VA 24589-2712
Phone
(434) 476-1040
Fax
(434) 476-1070
NPI assigned
Feb 21, 2013
Last updated
Feb 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Doris Doretha Chism
Title
Owner
Phone
(434) 476-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X CRF-279 VA Primary

Addresses

Primary practice location

1099 Bagwell Dr
Scottsburg, VA 24589-2712

Mailing address

1099 Bagwell Dr
Scottsburg, VA 24589-2712
Phone (434) 476-1040

Other names 1

  • Pathways Youth Services III Other name

National Provider Directory

National Provider Directory
Tax ID family
Pathways Youth Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1164762563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 BAGWELL DR",
            "city": "SCOTTSBURG",
            "state": "VA",
            "postal_code": "245892712",
            "telephone_number": "434-476-1040",
            "fax_number": "434-476-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 BAGWELL DR",
            "city": "SCOTTSBURG",
            "state": "VA",
            "postal_code": "245892712",
            "telephone_number": "434-476-1040",
            "fax_number": "434-476-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "CHISM",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "DORETHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-476-1040"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "CRF-279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathways Youth Services III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.