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General NPI Number Information
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NPI Number | 1801048889
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Entity Type | Organization
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Legal Business Name | PATHS TO INDEPENDENCE, INC.
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 3953 LOOMIS PKWY
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City | RAVENNA
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State | OH
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Zip | 44266-4201
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Country | US
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Telephone | 330-296-2851
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Fax | 330-296-8631
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Provider Business Mailing Address
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Address Line | 161 E MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-3129
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Country | US
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Telephone | 330-296-2851
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Fax | 330-296-8631
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANNA BARRETT
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Credential |
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Telephone | 330-296-2851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 24319
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License Number State | OH
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