Organization · Type 2 NPI

Kingdom Dominion, LLD

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Richmond, VA

NPI number 1174817050 Active

Practice location

7024 Omalley Dr
Richmond, VA 23234-2800

Call (804) 525-4345 Map

Fax (804) 562-7752

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X905-01-001 (VA)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1174817050

Kingdom Dominion, LLD's National Provider Identifier is 1174817050, issued on Jun 8, 2011. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Richmond, VA. The record was last updated on Jun 8, 2011.