Provider Demographics
NPI:1356053540
Name:PATHS OF HOPE
Entity type:Organization
Organization Name:PATHS OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TYREE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-776-4482
Mailing Address - Street 1:1004 R L COWARD RD
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29044-9455
Mailing Address - Country:US
Mailing Address - Phone:803-776-4482
Mailing Address - Fax:
Practice Address - Street 1:1004 R L COWARD RD
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:SC
Practice Address - Zip Code:29044-9455
Practice Address - Country:US
Practice Address - Phone:803-776-4482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility