Provider Demographics
NPI:1376937862
Name:DOMINION HEALTH SERVICES
Entity Type:Organization
Organization Name:DOMINION HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHALIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-5286
Mailing Address - Street 1:5651 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3568
Mailing Address - Country:US
Mailing Address - Phone:954-993-5286
Mailing Address - Fax:954-999-0675
Practice Address - Street 1:5651 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3568
Practice Address - Country:US
Practice Address - Phone:954-993-5286
Practice Address - Fax:954-999-0675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management