Organization
PATHWAY SERVICES UNLIMITED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN R BRUNDAGE (EXECUTIVE DIRECTOR)
(217) 479-2300
Entity
Organization
Contact information
Practice address
1905 W MORTON AVE, JACKSONVILLE, IL 62650-2620
(217) 479-2300
(217) 479-2305
Mailing address
1905 W MORTON AVE, JACKSONVILLE, IL 62650-2620
(217) 479-2300
(217) 479-2305
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
91S144
IL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
91S144
IL
Other
Enumeration date
04/16/2008
Last updated
03/11/2016
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