Healthcare Provider Details

I. General information

NPI: 1255695235
Provider Name (Legal Business Name): DREAMERS ACHIEVEMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 STIRLING WAY
ETNA OH
43062-7109
US

IV. Provider business mailing address

153 STIRLING WAY
ETNA OH
43062-7109
US

V. Phone/Fax

Practice location:
  • Phone: 614-354-4348
  • Fax: 740-919-5136
Mailing address:
  • Phone: 614-354-4348
  • Fax: 740-919-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANTOINETTE CELESTINE KORVAH
Title or Position: PRESIDENT & CEO
Credential: BS, RN, MPH
Phone: 614-354-4348