Healthcare Provider Details

I. General information

NPI: 1013337617
Provider Name (Legal Business Name): DREAMS INC SHORT TERM CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 04/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 RIDGEFIELD WAY
ODENVILLE AL
35120-5461
US

IV. Provider business mailing address

555 RIDGEFIELD WAY
ODENVILLE AL
35120-5461
US

V. Phone/Fax

Practice location:
  • Phone: 205-640-4282
  • Fax: 205-640-4282
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SJOHNSON GARDNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 205-640-4282