Healthcare Provider Details
I. General information
NPI: 1982649414
Provider Name (Legal Business Name): PRESCRIPTIONS FOR ENLIGHTENING PATHS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
890 POPLAR CHURCH RD SUITE 410
CAMP HILL PA
17011-2250
US
IV. Provider business mailing address
890 POPLAR CHURCH RD SUITE 410
CAMP HILL PA
17011-2250
US
V. Phone/Fax
- Phone: 717-303-0505
- Fax: 717-303-0507
- Phone: 717-303-0505
- Fax: 717-303-0507
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | MD059271-L |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
JANIECE
CHRISTINE
ANDREWS
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: M.D.
Phone: 717-303-0505