Provider Demographics
NPI:1578729489
Name:PATHWAYS PA
Entity Type:Organization
Organization Name:PATHWAYS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT RESIDENTIAL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HALDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:610-543-5022
Mailing Address - Street 1:310 AMOSLAND RD
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:PA
Mailing Address - Zip Code:19043-1216
Mailing Address - Country:US
Mailing Address - Phone:610-543-5022
Mailing Address - Fax:610-543-1549
Practice Address - Street 1:3617 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2603
Practice Address - Country:US
Practice Address - Phone:215-387-1470
Practice Address - Fax:215-222-3720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122820251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management