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General NPI Number Information
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NPI Number | 1194873174
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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 | 01/08/2007
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 4641 ROOSEVELT BLVD BLDG B
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City | PHILADELPHIA
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State | PA
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Zip | 19124-2343
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Country | US
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Telephone | 215-728-4597
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Fax |
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Provider Business Mailing Address
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Address Line | 8220 CASTOR AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-2729
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Country | US
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Telephone | 215-728-4597
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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 | MR. JEFF BROWN
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Credential |
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Telephone | 215-728-4597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 105100
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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