Provider Demographics
NPI:1851124911
Name:GOLDEN PATH HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GOLDEN PATH HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHIA
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:ENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-977-6894
Mailing Address - Street 1:11022 N 28TH DR STE 125
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-5636
Mailing Address - Country:US
Mailing Address - Phone:910-977-6894
Mailing Address - Fax:520-353-0181
Practice Address - Street 1:11022 N 28TH DR STE 125
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-5636
Practice Address - Country:US
Practice Address - Phone:910-977-6894
Practice Address - Fax:520-353-0181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty