Provider Demographics
NPI:1396596094
Name:DREAM & EMPOWER CONNECTION CENTER LLC
Entity type:Organization
Organization Name:DREAM & EMPOWER CONNECTION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-802-4054
Mailing Address - Street 1:825 PLUMMER DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2289
Mailing Address - Country:US
Mailing Address - Phone:602-802-4054
Mailing Address - Fax:
Practice Address - Street 1:5724 N 61ST ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2031
Practice Address - Country:US
Practice Address - Phone:602-802-4054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management