Provider Demographics
NPI:1235884388
Name:DREAM LIFE LEGACY, INC.
Entity Type:Organization
Organization Name:DREAM LIFE LEGACY, INC.
Other - Org Name:SENIORS HELPING SENIORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-604-5445
Mailing Address - Street 1:67 N ST ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3863
Mailing Address - Country:US
Mailing Address - Phone:513-604-5445
Mailing Address - Fax:
Practice Address - Street 1:761 W GRANADA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5107
Practice Address - Country:US
Practice Address - Phone:386-985-2292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care