Healthcare Provider Details

I. General information

NPI: 1295327815
Provider Name (Legal Business Name): DREAM WELLNESS SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2021
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 PARK CENTRAL BLVD STE A1
DECATUR GA
30035-3925
US

IV. Provider business mailing address

3719 MICAH CT
ELLENWOOD GA
30294-6224
US

V. Phone/Fax

Practice location:
  • Phone: 844-478-3267
  • Fax: 404-891-8992
Mailing address:
  • Phone: 404-314-4737
  • Fax: 404-891-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAREN JOHNSON DAVIS
Title or Position: WELLNESS PRACTIONER
Credential: H.C. OF WELLNESS
Phone: 844-478-3267