| NPI | 1194447300 |
|---|---|
| Former Legal Business Name | DIVINE PATHWAYS LLC |
| Entity Type | Organization |
| Authorized Contact | SHANE HANSEN Owner/Executive Director 606-875-0812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2022-09-14 |