Healthcare Provider Details

I. General information

NPI: 1083120125
Provider Name (Legal Business Name): DREAM CREATIVE OPPORTUNITIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2017
Last Update Date: 12/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21250 HARPER AVE
SAINT CLAIR SHORES MI
48080-2221
US

IV. Provider business mailing address

21250 HARPER AVE
SAINT CLAIR SHORES MI
48080-2221
US

V. Phone/Fax

Practice location:
  • Phone: 313-758-1696
  • Fax:
Mailing address:
  • Phone: 313-758-1696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CIERRA BELL
Title or Position: OWNER
Credential:
Phone: 313-758-1696