Provider Demographics
NPI:1629437314
Name:PATH OF LIFE MINISTRIES
Entity Type:Organization
Organization Name:PATH OF LIFE MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-786-9048
Mailing Address - Street 1:PO BOX 1445
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92502-1445
Mailing Address - Country:US
Mailing Address - Phone:951-786-9048
Mailing Address - Fax:951-786-9049
Practice Address - Street 1:2530 3RD ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3309
Practice Address - Country:US
Practice Address - Phone:951-275-8755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health