Provider Demographics
NPI:1497369540
Name:DREAM TEAM BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:DREAM TEAM BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:CAMARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:440-320-6543
Mailing Address - Street 1:6915 W 2ND WAY
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5319
Mailing Address - Country:US
Mailing Address - Phone:440-320-6543
Mailing Address - Fax:786-226-0641
Practice Address - Street 1:6915 W 2ND WAY
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5319
Practice Address - Country:US
Practice Address - Phone:440-320-6543
Practice Address - Fax:786-226-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-06
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty