Organization
DESTIN PATHWAYS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONDA LATRESE TOWNSEND (EXECUTIVE DIRECTOR)
(757) 676-5451
Entity
Organization
Contact information
Practice address
5283 WINDSOR BLVD, ZUNI, VA 23898
(757) 242-4059
Mailing address
20623 THOMAS WOODS TRL, ZUNI, VA 23898-2303
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2689
—
VA
Enumeration date
06/28/2017
Last updated
06/28/2017
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