Healthcare Provider Details

I. General information

NPI: 1639580590
Provider Name (Legal Business Name): DREAMS INC SHORT TERM NURSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/14/2014
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
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number56611
License Number StateAL

VIII. Authorized Official

Name: SANDRA J GARDNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 205-640-4282