Organization
DIVINE PATHWAYS SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWANDA CHANTELLE CHEATHAM (OWNER)
(804) 389-3201
Entity
Organization
Contact information
Practice address
917 WINDING TRAIL LN, RICHMOND, VA 23223-2289
(804) 389-3201
Mailing address
917 WINDING TRAIL LN, RICHMOND, VA 23223-2289
(804) 389-3201
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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