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General NPI Number Information
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NPI Number | 1477175842
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Entity Type | Organization
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Legal Business Name | DOMINION RECOVERY MANAGERS LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 7211 REGENCY SQUARE BLVD STE 150
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City | HOUSTON
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State | TX
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Zip | 77036-3137
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Country | US
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Telephone | 832-915-0642
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Fax | 832-209-8011
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Provider Business Mailing Address
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Address Line | 9002 CHIMNEY ROCK RD STE G238
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City | HOUSTON
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State | TX
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Zip | 77096-2509
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Country | US
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Telephone | 832-915-0642
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Fax | 832-209-8011
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Authorized Official
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Title or Position | CEO
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Name | EBONY M SHELTON
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Credential |
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Telephone | 832-915-0642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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