Provider Demographics
NPI:1629940317
Name:PATHWAYTOHOPELLC
Entity type:Organization
Organization Name:PATHWAYTOHOPELLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-750-5677
Mailing Address - Street 1:4200 HARFORD TER
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-3124
Mailing Address - Country:US
Mailing Address - Phone:443-750-5677
Mailing Address - Fax:207-901-9121
Practice Address - Street 1:3012 DUNMURRY RD
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-5308
Practice Address - Country:US
Practice Address - Phone:443-750-5677
Practice Address - Fax:207-901-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility