Healthcare Provider Details

I. General information

NPI: 1922830538
Provider Name (Legal Business Name): PATHWAY TO EVERYDAY LIFE HUMAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 N LAUREL ST APT 1N
HAZLETON PA
18201-5180
US

IV. Provider business mailing address

565 N LAUREL ST APT 1N
HAZLETON PA
18201-5180
US

V. Phone/Fax

Practice location:
  • Phone: 484-209-9981
  • Fax: 484-214-0088
Mailing address:
  • Phone: 484-209-9981
  • Fax: 484-214-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CAROL TAYLOR
Title or Position: CEO
Credential:
Phone: 516-468-2898