# DOMINION OUTPATIENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275800765
- **Authorized official:** MRS. KIMBERLY HINES LCSW (SERVICE DIRECTOR)
- **Authorized official phone:** (804) 272-2000

## Contact information

- **Practice address:** 6767 FOREST HILL AVE, SUITE 307, RICHMOND, VA 23225-1856
- **Practice address phone:** (804) 272-2000
- **Practice address fax:** (804) 272-2030
- **Mailing address:** 6767 FOREST HILL AVENUE, SUITE 307, RICHMOND, VA 23225
- **Mailing address phone:** (804) 272-2000
- **Mailing address fax:** (804) 272-2030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 0904007163 | VA | Yes |

## Other

- **Enumeration date:** 11/28/2011
- **Last updated:** 11/28/2011