National Provider Identifier Database

DOMINION RESIDENCE OF MARYLANDINC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

DOMINION RESIDENCE OF MARYLAND,INC
4415 NICOLE DR STE G
LANHAM, MD20706-4357
Phone: 301-624-9404
Fax: 301-306-2022
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for DOMINION RESIDENCE OF MARYLAND,INC

NPI Number 1871255687
Legal business name
LBN
DOMINION RESIDENCE OF MARYLAND,INC
Authorized official THOMAS BECHEM - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 10/08/2021
Last updated 10/08/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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