Provider Demographics
NPI:1053880260
Name:DOMINION HOME CARE LLC
Entity type:Organization
Organization Name:DOMINION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARALU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-717-7030
Mailing Address - Street 1:5605 BURBERRY CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5380
Mailing Address - Country:US
Mailing Address - Phone:301-717-7030
Mailing Address - Fax:
Practice Address - Street 1:5605 BURBERRY CT
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5380
Practice Address - Country:US
Practice Address - Phone:301-717-7030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty