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Organization

DOMAIN MEDICAL HOME HEALTH & STAFFING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GIBSON ERHUNMWUNSE CRNP (CEO)
(703) 299-4949
Entity
Organization

Contact information

Practice address
2121 EISENHOWER AVE, SUITE 112, ALEXANDRIA, VA 22314-4698
(703) 299-4949
(703) 299-6699
Mailing address
2121 EISENHOWER AVE, SUITE 112, ALEXANDRIA, VA 22314-4698
(703) 299-4949
(703) 299-6699

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC0-11711
VA

Other

Enumeration date
01/12/2011
Last updated
04/04/2011
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