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General NPI Number Information
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NPI Number | 1619789823
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Entity Type | Organization
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Legal Business Name | PEACEFUL PATHWAY SERVICES, LLC
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 132 N SYCAMORE ST STE A STUDIO 13
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City | PETERSBURG
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State | VA
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Zip | 23803
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Country | US
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Telephone | 804-926-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 OLD IRON RD
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City | HOPEWELL
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State | VA
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Zip | 23860-6601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PEDRO BERRIOS
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Credential |
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Telephone | 804-926-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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