Organization
KINGDOM DOMINION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEVELAND HILL (CFO)
(804) 525-4345
Entity
Organization
Contact information
Practice address
7024 O MALLEY DR, SAME, RICHMOND, VA 23234
(804) 525-4345
Mailing address
7024 O MALLEY DR., RICHMOND, VA 23234
(804) 525-4345
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
S1895533
VA
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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