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General NPI Number Information
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NPI Number | 1336279488
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Entity Type | Organization
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Legal Business Name | DREAMS COME TRUE INC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3242 SWANDALE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4404
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Country | US
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Telephone | 210-979-6420
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Fax | 210-308-7411
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Provider Business Mailing Address
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Address Line | 3242 SWANDALE ST
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4404
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Country | US
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Telephone | 210-979-6420
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Fax | 210-308-7411
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | MR. ED KELLEYADMINISTRATOR
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Credential |
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Telephone | 210-979-6420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State | TX
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