Organization
KINGDOM DOMINION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEVELAND L. HILL (OWNER)
(540) 586-4023
Entity
Organization
Contact information
Practice address
7024 OMALLEY DR, RICHMOND, VA 23234-2800
(540) 586-4023
(540) 586-0747
Mailing address
7024 OMALLEY DR, RICHMOND, VA 23234-2800
(540) 586-4023
(540) 586-0747
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
905-02-014
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
905-02-014
DBHDS
VA
Enumeration date
12/31/2009
Last updated
12/31/2009
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