Dominion Lifestyle Serivces, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

DOMINION LIFESTYLE SERIVCES, LLC

Practice address

5368 Mortons Ford Way
Haymarket, VA 20169-4520

Phone

(703) 753-2503

NPI assigned

Jun 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lynn Turner Sivels

Title

Executive Director / Owner

Phone

(703) 753-2503

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1639338239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5368 MORTONS FORD WAY",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201694520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5368 MORTONS FORD WAY",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "201694520",
            "telephone_number": "703-753-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION LIFESTYLE SERIVCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "SIVELS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "TURNER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR / OWNER",
        "authorized_official_telephone_number": "703-753-2503",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter F Demitry, MD
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• Christine Dooley, MPH, RDN
• Nicholas Dugan, MD
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• Carry Durham, LPC
• Elevate a Wellness Practice LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Haymarket, VA
• Providers in Haymarket, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.