Provider Demographics
NPI:1821397878
Name:WRIGHT DREAM
Entity Type:Organization
Organization Name:WRIGHT DREAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HOME HEALTH AIDE ADMINISTRATO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:LA 'COLE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-300-2820
Mailing Address - Street 1:706 S SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:706 S SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619
Practice Address - Country:US
Practice Address - Phone:574-300-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251300000XAgenciesLocal Education Agency (LEA)
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty