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General NPI Number Information
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NPI Number | 1154485019
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Entity Type | Organization
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Legal Business Name | PATH (PEOPLE ACTING TO HELP), INC.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 1919 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134
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Country | US
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Telephone | 215-728-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-3816
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Country | US
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Telephone | 215-728-4600
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. KAREN L GRAVES
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Credential | PHD
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Telephone | 215-316-0794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 900304
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License Number State | PA
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