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General NPI Number Information
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NPI Number | 1578729489
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Entity Type | Organization
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Legal Business Name | PATHWAYS PA
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 3617 LANCASTER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-2603
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Country | US
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Telephone | 215-387-1470
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Fax | 215-222-3720
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Provider Business Mailing Address
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Address Line | 310 AMOSLAND RD
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City | HOLMES
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State | PA
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Zip | 19043-1216
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Country | US
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Telephone | 610-543-5022
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Fax | 610-543-1549
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Authorized Official
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Title or Position | VICE PRESIDENT RESIDENTIAL SERVICES
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Name | MS. JOAN M HALDEMAN
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Credential | LSW
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Telephone | 610-543-5022
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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 | 122820
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License Number State | PA
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