Provider Demographics
NPI:1992406094
Name:HEALING PATHWAYS TRANSITIONAL HOMES
Entity type:Organization
Organization Name:HEALING PATHWAYS TRANSITIONAL HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LIDAIRIOUS
Authorized Official - Middle Name:JAWAN
Authorized Official - Last Name:HAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-545-6789
Mailing Address - Street 1:1667 STATE AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45204
Mailing Address - Country:US
Mailing Address - Phone:513-545-6789
Mailing Address - Fax:
Practice Address - Street 1:1667 STATE AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45204
Practice Address - Country:US
Practice Address - Phone:513-545-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities