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General NPI Number Information
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NPI Number | 1629437314
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Entity Type | Organization
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Legal Business Name | PATH OF LIFE MINISTRIES
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 2530 3RD ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-3309
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Country | US
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Telephone | 951-275-8755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1445
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City | RIVERSIDE
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State | CA
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Zip | 92502-1445
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Country | US
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Telephone | 951-786-9048
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Fax | 951-786-9049
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Authorized Official
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Title or Position | CEO
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Name | MRS. CHRIS OBERG
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Credential |
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Telephone | 951-786-9048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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