Provider Demographics
NPI:1508759366
Name:A LIGHTENED PATH
Entity type:Organization
Organization Name:A LIGHTENED PATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:TATIANA
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:323-399-2595
Mailing Address - Street 1:3310 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5230
Mailing Address - Country:US
Mailing Address - Phone:323-399-2595
Mailing Address - Fax:
Practice Address - Street 1:3310 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-5230
Practice Address - Country:US
Practice Address - Phone:323-399-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management