=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063604213
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DREAM CATCHERS CASE MANAGEMENT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2007
-----------------------------------------------------
Last Update Date | 08/13/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 S. BROADWAY ST. SUITE 900-D
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67202-4278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-771-7134
-----------------------------------------------------
Fax | 316-771-7112
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 S. BROADWAY ST. SUITE 900-D
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67202-4278
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-771-7134
-----------------------------------------------------
Fax | 316-771-7112
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KATHLEEN L. BLACKBURN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 316-771-7134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------