Provider Demographics
NPI:1265703201
Name:THE DREAM ACADEMY, INC.
Entity type:Organization
Organization Name:THE DREAM ACADEMY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-618-7548
Mailing Address - Street 1:127 LIBERIA ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-2251
Mailing Address - Country:US
Mailing Address - Phone:910-618-7548
Mailing Address - Fax:
Practice Address - Street 1:302 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-1730
Practice Address - Country:US
Practice Address - Phone:910-618-7548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No253J00000XAgenciesFoster Care Agency
No347B00000XTransportation ServicesBus
No347E00000XTransportation ServicesTransportation Broker