| NPI | 1871255687 |
|---|---|
| Former Legal Business Name | DOMINION RESIDENCE OF MARYLAND, INC |
| Entity Type | Organization |
| Authorized Contact | THOMAS BECHEM Executive Director 301-624-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2021-10-08 |