Organization
10 OLD DOMINION OPERATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY J VAUGHN (REIMBURSEMENT ANALYST)
(240) 595-6025
Entity
Organization
Contact information
Practice address
10 OLD DIAMOND HILL RD, CUMBERLAND, RI 02864-4611
(410) 333-3393
Mailing address
10 OLD DIAMOND HILL RD, CUMBERLAND, RI 02864-4611
(410) 333-3393
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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