MEDICARE: THE DREAM CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251X00000X	Supports Brokerage Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1306562707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DREAM CENTER

Provider Business Mailing Address
First Line	:	2301 BELLEVUE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-4017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 BELLEVUE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-4017
Country	:	US
Telephone Number	:	213-273-7000
Fax Number	:

Authorized Official
Title or Position	:	GRANTS MANAGER
Name	:	RICHARD JOHNSON
Credential	:
Telephone Number	:	915-263-0683

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	01/28/2023

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Directions to “THE DREAM CENTER ” Practice Location

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