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Organization

DYVINE ELEVATION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUCRETIA ETHERIDGE (OWNER)
(757) 652-3310
Entity
Organization

Contact information

Practice address
4707 PARVATHI CT, VIRGINIA BEACH, VA 23462-4465
(757) 652-3310
Mailing address
4707 PARVATHI CT, VIRGINIA BEACH, VA 23462-4465
(757) 652-3310

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
09/16/2025
Last updated
09/16/2025
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