Provider Demographics
NPI: | 1235018730 |
---|---|
Name: | AUTUMN PATHWAYS INC |
Entity type: | Organization |
Organization Name: | AUTUMN PATHWAYS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | PHILIP |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | OKOJIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 443-759-1137 |
Mailing Address - Street 1: | 101 N HAVEN ST |
Mailing Address - Street 2: | THIRD FLOOR STE N |
Mailing Address - City: | BALTIMORE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21224 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-449-7119 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 101 N HAVEN ST |
Practice Address - Street 2: | THIRD FLOOR STE N |
Practice Address - City: | BALTIMORE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21224 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-449-7119 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-08-28 |
Last Update Date: | 2025-08-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
No | 251E00000X | Agencies | Home Health | |
No | 253Z00000X | Agencies | In Home Supportive Care |