Healthcare Provider Details

I. General information

NPI: 1962372102
Provider Name (Legal Business Name): DREAM HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4430 BUTLER FARMS DR
COLUMBUS OH
43207-5010
US

IV. Provider business mailing address

4430 BUTLER FARMS DR
COLUMBUS OH
43207-5010
US

V. Phone/Fax

Practice location:
  • Phone: 740-400-3385
  • Fax:
Mailing address:
  • Phone: 740-400-3385
  • Fax:

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: IYA LIBAN JILO
Title or Position: OWNER
Credential:
Phone: 740-400-3385