Healthcare Provider Details

I. General information

NPI: 1265547160
Provider Name (Legal Business Name): PATH (PEOPLE ACTING TO HELP), INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 COTTMAN AVE
PHILADELPHIA PA
19111-3816
US

IV. Provider business mailing address

1919 COTTMAN AVE
PHILADELPHIA PA
19111-3816
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-4600
  • Fax:
Mailing address:
  • Phone: 215-728-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number121680
License Number StatePA

VIII. Authorized Official

Name: MS. JESSICA VARELA CORREA
Title or Position: CHIEF OPERATING OFFICER
Credential: MBA
Phone: 215-728-4597