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General NPI Number Information
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NPI Number | 1396568697
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Entity Type | Organization
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Legal Business Name | DREAM CAROLINA COMMUNITY CARE, LLC
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 475 MUSEUM RD
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City | ROCK HILL
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State | SC
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Zip | 29732-8220
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Country | US
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Telephone | 980-202-2338
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Fax |
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Provider Business Mailing Address
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Address Line | 475 MUSEUM RD
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City | ROCK HILL
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State | SC
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Zip | 29732-8220
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATONYA POMPEY BURGESS
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Credential |
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Telephone | 980-202-2338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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