Organization
KINGDOM DOMINION, LLD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEVELAND L. HILL (OWNER)
(804) 525-4345
Entity
Organization
Contact information
Practice address
7024 OMALLEY DR, RICHMOND, VA 23234-2800
(804) 525-4345
(804) 562-7752
Mailing address
7024 OMALLEY DR, RICHMOND, VA 23234-2800
(804) 525-4345
(804) 562-7752
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
905-01-001
VA
Other
Enumeration date
06/08/2011
Last updated
06/08/2011
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