- Enrollment id
- O20160310001526
- Enrollment state
- PA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1891793543
- Multiple npi flag
- N
- Ccn
- 397733
- Associate id
- 2668778044
- Organization name
- PATHWAYS HEALTHCARE PENNSYLVANIA LLC
- Doing business as name
- PATHWAYS HEALTHCARE
- Incorporation date
- 2015-06-03
- Incorporation state
- PA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 270 PIERCE ST
- Address line 2
- STE 308
- City
- KINGSTON
- State
- PA
- Zip code
- 187045141