Healthcare Provider Details

I. General information

NPI: 1356183040
Provider Name (Legal Business Name): DREAM PROVIDER CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 NEW BERN AVE
RALEIGH NC
27610-1551
US

IV. Provider business mailing address

216 STEWART PKWY
WASHINGTON NC
27889-4972
US

V. Phone/Fax

Practice location:
  • Phone: 252-946-0585
  • Fax: 252-946-0580
Mailing address:
  • Phone: 252-946-0585
  • Fax: 252-946-0580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ADREANNE TURNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-946-0585