MEDICARE: DREAM BUILDERS OF ARIZONA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	320800000X	Mental Illness Community Based Residential Treatment Facility
2	323P00000X	Psychiatric Residential Treatment Facility
3	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1063059525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAM BUILDERS OF ARIZONA

Provider Business Mailing Address
First Line	:	5115 W SUMTER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8247
Country	:	US
Telephone Number	:	520-500-2992
Fax Number	:	520-744-3521

Provider Business Practice Location Address
First Line	:	5115 W SUMTER DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8247
Country	:	US
Telephone Number	:	520-500-2992
Fax Number	:	520-744-3521

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	CHRIS DAVIS
Credential	:
Telephone Number	:	520-500-2992

Provider Enumeration Date	:	12/04/2019
Last Update Date	:	03/05/2020

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Directions to “DREAM BUILDERS OF ARIZONA ” Practice Location

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