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NPI 1740865989

NPI 1740865989 : DREAMCATCHER HOME CARE AND TRANSPORT LLC : PINON, AZ

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General NPI Number Information
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    NPI Number           |    1740865989
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    Entity Type          |    Organization 
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    Legal Business Name  |    DREAMCATCHER HOME CARE AND TRANSPORT LLC 
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Dates
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    Enumeration Date     |    03/09/2021
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    Last Update Date     |    03/30/2021
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Provider Practice Location Address
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    Address Line         |    100 NORTH NAVAJO ROUTE 673 WHIPPOORWILL
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    City                 |    PINON
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    State                |    AZ
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    Zip                  |    86510
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    Country              |    US
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    Telephone            |    928-725-2090
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1212 
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    City                 |    PINON
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    State                |    AZ
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    Zip                  |    86510-1212
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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    |    PRESIDENT
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    Name                 |     JORDAN  WARTZ 
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    Credential           |    
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    Telephone            |    928-725-2090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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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        |    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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