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General NPI Number Information
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NPI Number | 1457997744
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Entity Type | Organization
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Legal Business Name | DREAM STREET CARE LLC
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 37412 N DREAM STREET
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City | CAREFREE
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State | AZ
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Zip | 85377
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Country | US
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Telephone | 480-664-7566
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Fax | 480-664-7195
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Provider Business Mailing Address
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Address Line | 37412 N DREAM ST P.O.BOX 2800-395
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City | CAREFREE
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State | AZ
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Zip | 85377
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Country | US
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Telephone | 480-664-7566
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Fax | 480-664-7195
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Authorized Official
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Title or Position | MANAGER
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Name | MARIANA BALAN
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Credential |
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Telephone | 480-664-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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