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General NPI Number Information
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NPI Number | 1306080650
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Entity Type | Organization
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Legal Business Name | DOMINION SERVICES
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 1930 FORT BRAGG RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-6806
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Country | US
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Telephone | 910-527-0890
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 FORT BRAGG RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-6806
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Country | US
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Telephone | 910-527-0890
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. TONI GRESSETT
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Credential |
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Telephone | 910-527-0890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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