Provider Demographics
NPI:1942788062
Name:DREAM HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:DREAM HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-606-4701
Mailing Address - Street 1:1101 E CUMBERLAND AVE STE 301-I
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4231
Mailing Address - Country:US
Mailing Address - Phone:813-488-7430
Mailing Address - Fax:813-488-7431
Practice Address - Street 1:1101 E CUMBERLAND AVE STE 301-I
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4231
Practice Address - Country:US
Practice Address - Phone:813-488-7430
Practice Address - Fax:813-488-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health