Provider Demographics
NPI:1164765665
Name:JABEZ'S DREAM
Entity Type:Organization
Organization Name:JABEZ'S DREAM
Other - Org Name:ESTHER'S HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRIMARY OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:912-604-8355
Mailing Address - Street 1:619 W. 37TH STREET
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31415
Mailing Address - Country:US
Mailing Address - Phone:912-335-2508
Mailing Address - Fax:912-335-2543
Practice Address - Street 1:619 W. 37TH STREET
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31415
Practice Address - Country:US
Practice Address - Phone:912-335-2508
Practice Address - Fax:912-335-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002835261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care