Healthcare Provider Details

I. General information

NPI: 1407332455
Provider Name (Legal Business Name): DREAM HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19503 GALWAY AVE
CARSON CA
90746-1923
US

IV. Provider business mailing address

20695 S WESTERN AVE STE 132
TORRANCE CA
90501-1834
US

V. Phone/Fax

Practice location:
  • Phone: 562-595-9021
  • Fax: 562-427-4121
Mailing address:
  • Phone: 424-271-7414
  • Fax: 424-731-7141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number198209626
License Number StateCA

VIII. Authorized Official

Name: CORA MANALANG
Title or Position: CEO
Credential:
Phone: 562-595-9021