Path Light Agency LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

PATH LIGHT AGENCY LLC

Practice address

526 SE 128TH Ave
Portland, OR 97233-1602

Phone

(503) 810-7879

Fax

(971) 339-3946

NPI assigned

Jun 4, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Elijah N KaranjaNPI 1720829898

Title

Provider

Phone

(503) 810-7879

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elijah Karanja

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1720829898

  Community Based Residential Treatment Facility, Mental Illness

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1801637756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 SE 128TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331602",
            "telephone_number": "503-810-7879",
            "fax_number": "971-339-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 SE 128TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331602",
            "telephone_number": "503-810-7879",
            "fax_number": "971-339-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH LIGHT AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "KARANJA",
        "authorized_official_first_name": "ELIJAH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "503-810-7879",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twisha Mit Patel, DDS
• Sabine Gisela Pater, LAC
• Hana Marijke Paterno, ND
• Joe J Paterno, P.T.
• Amy Paterson Sandie
• Path Solaris LLC
• Path With Heart Therapy LLC
• Pathfinders of Oregon
• Pathoc LLC
• Pathology Associates Medical Laboratories, LLC

• Mental Illness Community Based Residential Treatment Facility in Portland, OR
• Providers in Portland, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.