Provider Demographics
NPI:1083338339
Name:AMERICAN DREAM HEALTHCARE LLC
Entity Type:Organization
Organization Name:AMERICAN DREAM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KWABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKYERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-492-7939
Mailing Address - Street 1:16160 W DURANGO ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-3443
Mailing Address - Country:US
Mailing Address - Phone:785-492-7939
Mailing Address - Fax:
Practice Address - Street 1:16160 W DURANGO ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-3443
Practice Address - Country:US
Practice Address - Phone:785-492-7939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness