Provider Demographics
NPI:1104355734
Name:ANN'S DREAM HEALTHCARE 1
Entity Type:Organization
Organization Name:ANN'S DREAM HEALTHCARE 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:D'ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-258-7114
Mailing Address - Street 1:1409 WASHINGTON AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1917
Mailing Address - Country:US
Mailing Address - Phone:636-730-8333
Mailing Address - Fax:314-696-8150
Practice Address - Street 1:1409 WASHINGTON AVE STE 414
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1917
Practice Address - Country:US
Practice Address - Phone:636-730-8333
Practice Address - Fax:314-696-8150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care