Provider Demographics
NPI:1295327815
Name:DREAM WELLNESS SOLUTIONS
Entity type:Organization
Organization Name:DREAM WELLNESS SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:WELLNESS PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:HC OF WELLNESS
Authorized Official - Phone:844-478-3267
Mailing Address - Street 1:3719 MICAH CT
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6224
Mailing Address - Country:US
Mailing Address - Phone:404-314-4737
Mailing Address - Fax:404-891-8992
Practice Address - Street 1:2500 PARK CENTRAL BLVD STE A1
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3925
Practice Address - Country:US
Practice Address - Phone:844-478-3267
Practice Address - Fax:404-891-8992
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREAM WELLNESS SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-04
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment