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General NPI Number Information
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NPI Number | 1689215436
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Entity Type | Organization
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Legal Business Name | ONE PATH ONE PURPOSE, LLC
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 10/02/2019
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Provider Practice Location Address
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Address Line | 1909 HUGUENOT RD STE 305
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4314
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Country | US
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Telephone | 804-464-1884
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Fax | 804-464-4150
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Provider Business Mailing Address
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Address Line | 1909 HUGUENOT RD STE 305
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4314
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Country | US
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Telephone | 804-464-1884
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Fax | 804-464-4150
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Authorized Official
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Title or Position | OWNER
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Name | DAMOND WHITAKER
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Credential |
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Telephone | 804-477-2110
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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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