MEDICARE: DREAM CATCHER'S HOME CARE LLC

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	372600000X	Adult Companion
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1518654540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAM CATCHER'S HOME CARE LLC

Provider Business Mailing Address
First Line	:	2819 FITZGERALD ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-4348
Country	:	US
Telephone Number	:	904-330-9689
Fax Number	:

Provider Business Practice Location Address
First Line	:	2819 FITZGERALD ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-4348
Country	:	US
Telephone Number	:	904-330-9689
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALLISON HOWARD
Credential	:
Telephone Number	:	904-330-9689

Provider Enumeration Date	:	04/19/2023
Last Update Date	:	04/19/2023

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