Provider Demographics
NPI:1427413863
Name:PATH (PEOPLE ACTING TO HELP), INC.
Entity Type:Organization
Organization Name:PATH (PEOPLE ACTING TO HELP), INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH INFORMATION SYSTEMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURGEOIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-728-4610
Mailing Address - Street 1:8220 CASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2729
Mailing Address - Country:US
Mailing Address - Phone:215-728-4600
Mailing Address - Fax:215-745-6511
Practice Address - Street 1:6818 DITMAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-2204
Practice Address - Country:US
Practice Address - Phone:215-728-4600
Practice Address - Fax:215-745-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA125170320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness