Organization
PATHWAYS RESIDENTIAL AND SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANETTE WADE (OWNER/DIRECTOR)
(817) 706-5360
Entity
Organization
Contact information
Practice address
2528 COLDSTREAM DR, FORT WORTH, TX 76123-1238
(817) 882-6237
(817) 882-6238
Mailing address
2528 COLDSTREAM DR, FORT WORTH, TX 76123-1238
(817) 882-6237
(817) 882-6238
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/03/2016
Last updated
04/03/2016
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