NPIMap

Organization Active NPI

Pathway Living Center, Inc

  • Community/Behavioral Health Agency
  • Clinton, IA
National Provider Identifier
1821218983
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHWAY LIVING CENTER, INC
Practice address
562 2ND Ave S
Clinton, IA 52732
Phone
(563) 242-3687
Fax
(563) 242-9319
NPI assigned
Apr 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Melissa Mary Peterson, LBSW, MBA
Title
Executive Director
Phone
(563) 242-3687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X IA Primary

Addresses

Primary practice location

562 2ND Ave S
Clinton, IA 52732

Mailing address

P.O. Box 1896
Clinton, IA 52733-1896
Phone (563) 242-3687

Other identifiers 2

IdentifierTypeStateIssuer
0423400MedicaidIA
0231548MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Pathway Living Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821218983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1896",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527331896",
            "telephone_number": "563-242-3687",
            "fax_number": "563-242-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 2ND AVE S",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "52732",
            "telephone_number": "563-242-3687",
            "fax_number": "563-242-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY LIVING CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "563-242-3687",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LBSW, MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0423400",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231548",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.