Provider Demographics
NPI:1154485019
Name:PATH (PEOPLE ACTING TO HELP), INC.
Entity Type:Organization
Organization Name:PATH (PEOPLE ACTING TO HELP), INC.
Other - Org Name:PATH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-316-0794
Mailing Address - Street 1:1919 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3816
Mailing Address - Country:US
Mailing Address - Phone:215-728-4600
Mailing Address - Fax:
Practice Address - Street 1:1919 CASTOR AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-728-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA900304261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000015840057Medicaid