Healthcare Provider Details

I. General information

NPI: 1689639304
Provider Name (Legal Business Name): KIDS HELPING KIDS, A PATHWAY FAMILY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6070 BRANCH HILL-GUINEA PIKE
MILFORD OH
45150
US

IV. Provider business mailing address

6070 BRANCH HILL-GUINEA PIKE
MILFORD OH
45150
US

V. Phone/Fax

Practice location:
  • Phone: 513-575-7300
  • Fax:
Mailing address:
  • Phone: 513-575-7300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number12497
License Number StateOH

VIII. Authorized Official

Name: MRS. PENNY G. WALKER
Title or Position: VICE PRESIDENT
Credential: M. S., LICDC
Phone: 513-575-7300