Organization
DOMINION RESIDENCE OF MARYLAND,INC
Active
Other names
DOMINION RESIDENCE OF MARYLAND, INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS BECHEM (EXECUTIVE DIRECTOR)
(301) 624-9404
Entity
Organization
Contact information
Practice address
4415 NICOLE DR STE G, LANHAM, MD 20706-4357
(301) 624-9404
(301) 306-2022
Mailing address
4415 NICOLE DR STE G, LANHAM, MD 20706-4357
(301) 624-9404
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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