Healthcare Provider Details

I. General information

NPI: 1346116316
Provider Name (Legal Business Name): A PROSPEROUS PATH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 LINCOLN PL
HOPEWELL VA
23860-6442
US

IV. Provider business mailing address

1513 LINCOLN PL
HOPEWELL VA
23860-6442
US

V. Phone/Fax

Practice location:
  • Phone: 804-704-2092
  • Fax:
Mailing address:
  • Phone: 804-704-2092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARKIEST S DAVIS
Title or Position: CEO/OWNER
Credential:
Phone: 804-704-2092