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General NPI Number Information
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NPI Number | 1063163350
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Entity Type | Organization
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Legal Business Name | PATH (PEOPLE ASSISTING THE HOMELESS)
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 1865 HOTEL CIR S
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City | SAN DIEGO
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State | CA
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Zip | 92108-3319
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Country | US
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Telephone | 619-881-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 340 N MADISON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90004-3504
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Country | US
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Telephone | 323-644-2224
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Fax |
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Authorized Official
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Title or Position | CCAO
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Name | LA KEISHIA CHILDERS
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Credential | MSW
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Telephone | 323-644-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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