1982651600 NPI number — LIFEPATH, INC.

Table of content: (NPI 1982651600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982651600 NPI number — LIFEPATH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFEPATH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY FOUNDATION FOR HUMAN DEVELOPMENT, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982651600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3500 HIGH POINT BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017-7803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-264-5724
Provider Business Mailing Address Fax Number:
610-264-2707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3500 HIGH POINT BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-7803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-264-5724
Provider Business Practice Location Address Fax Number:
610-264-2707
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COLEMAN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
610-264-5724

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X , with the licence number: 142420 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 545510 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 555140 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X , with the licence number: 629740 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: 112030 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320900000X , with the licence number: 112030 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100001074 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LI1334230 . This is a "BLUE CROSS/BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: DA2402 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11500557 . This is a "KEYSTONE MERCY HEALTH PLA" identifier . This identifiers is of the category "OTHER".




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