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General NPI Number Information
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NPI Number | 1972416493
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Entity Type | Organization
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Legal Business Name | DOMINICUS HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 4220 GLENN DALE RD
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City | BOWIE
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State | MD
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Zip | 20720-3537
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Country | US
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Telephone | 301-624-9961
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Fax |
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Provider Business Mailing Address
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Address Line | 5116 KENILWORTH AVE APT 10
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City | HYATTSVILLE
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State | MD
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Zip | 20781-2531
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Country | US
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Telephone | 301-624-9961
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOMINIC NGOH TEBIT
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Credential |
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Telephone | 301-624-9961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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