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General NPI Number Information
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NPI Number | 1013885995
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Entity Type | Organization
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Legal Business Name | DREAM-LIVE-HOPE FOUNDATION
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 340 E KELSO ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-2703
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Country | US
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Telephone | 310-714-7234
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Fax | 562-222-7924
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Provider Business Mailing Address
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Address Line | 340 E KELSO ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-2703
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Country | US
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Telephone | 310-714-7234
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Fax | 562-222-7924
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. KEVIN CHRISTOPHER WATERS
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Credential |
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Telephone | 310-714-7234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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