Provider Demographics
NPI:1275883068
Name:DREAMCATCHER SUPPORT SYSTEMS, LLC
Entity Type:Organization
Organization Name:DREAMCATCHER SUPPORT SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-629-1049
Mailing Address - Street 1:2413 W CANTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7326
Mailing Address - Country:US
Mailing Address - Phone:918-629-1049
Mailing Address - Fax:918-895-1302
Practice Address - Street 1:2413 W CANTON ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7326
Practice Address - Country:US
Practice Address - Phone:918-629-1049
Practice Address - Fax:918-895-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health