Organization
PATHWAYS YOUTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS CHISM (OWNER)
(434) 476-1624
Entity
Organization
Contact information
Practice address
1103 BAGWELL DR, SCOTTSBURG, VA 24589-2711
(434) 476-1624
(434) 476-1070
Mailing address
1010 MARIONS TRL, HALIFAX, VA 24558-3126
(434) 476-5059
(434) 476-5060
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1802-01-001
VA
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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