MEDICARE: AMERICANS DREAM HOME CARE AGENCY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1861128860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICANS DREAM HOME CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	12888 PASTURES WAY
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-7634
Country	:	US
Telephone Number	:	239-324-6799
Fax Number	:	239-324-6799

Provider Business Practice Location Address
First Line	:	3049 CLEVELAND AVE STE 243
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7046
Country	:	US
Telephone Number	:	239-324-6799
Fax Number	:	239-324-6799

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ROSETTE DIE SAINT JOUR
Credential	:
Telephone Number	:	239-324-6799

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	08/01/2022

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