Provider Demographics
NPI:1063857639
Name:DREAMCATCHER AT PARADISE HEIGHTS
Entity Type:Organization
Organization Name:DREAMCATCHER AT PARADISE HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE CO-ORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-314-1650
Mailing Address - Street 1:12035 E MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-6011
Mailing Address - Country:US
Mailing Address - Phone:480-314-1650
Mailing Address - Fax:480-314-1097
Practice Address - Street 1:7049 N 23RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5610
Practice Address - Country:US
Practice Address - Phone:602-410-6671
Practice Address - Fax:602-331-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL7292H311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home