Healthcare Provider Details

I. General information

NPI: 1033492970
Provider Name (Legal Business Name): AMERICA'S MEDICAL DREAM HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 E MAIN ST STE 203
COLUMBUS OH
43205-2081
US

IV. Provider business mailing address

881 E. MAIN STREET SUITE 203
COLUMBUS OH
43205
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-7834
  • Fax: 614-252-7839
Mailing address:
  • Phone: 614-252-7834
  • Fax: 614-252-7839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DEBRA BURKE
Title or Position: CEO
Credential:
Phone: 614-252-7834