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Organization

PATHWAYS TO INDEPENDENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SALENCIA ELAINE TALLEY (CO OWNER)
(214) 878-1080
Entity
Organization

Contact information

Practice address
4629 CHALK CT, GRAND PRAIRIE, TX 75052-1714
(214) 878-1080
(972) 522-0291
Mailing address
4629 CHALK CT, GRAND PRAIRIE, TX 75052-1714
(214) 878-1080
(972) 522-0291

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
TX
251S00000X
Community/Behavioral Health Agency
Primary
TX

Other

Enumeration date
11/11/2013
Last updated
11/11/2013
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