Provider Demographics
NPI:1629792718
Name:THE STRAIGHT PATH PROGRAM
Entity Type:Organization
Organization Name:THE STRAIGHT PATH PROGRAM
Other - Org Name:THE STRAIGHT PATH PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:CURRY
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-214-3460
Mailing Address - Street 1:2840 LINCOLN WAY E UNIT B
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-3792
Mailing Address - Country:US
Mailing Address - Phone:234-214-3460
Mailing Address - Fax:
Practice Address - Street 1:2840 LINCOLN WAY E UNIT B
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3792
Practice Address - Country:US
Practice Address - Phone:234-214-3460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty