Provider Demographics
NPI:1467715573
Name:DREAMS DAY SPA
Entity Type:Organization
Organization Name:DREAMS DAY SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-522-0316
Mailing Address - Street 1:4933 GRAND STRAND DR
Mailing Address - Street 2:APT 101
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2717
Mailing Address - Country:US
Mailing Address - Phone:757-522-0316
Mailing Address - Fax:
Practice Address - Street 1:4933 GRAND STRAND DR
Practice Address - Street 2:APT 101
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2717
Practice Address - Country:US
Practice Address - Phone:757-522-0316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization