Provider Demographics
NPI:1457997744
Name:DREAM STREET CARE LLC
Entity Type:Organization
Organization Name:DREAM STREET CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-664-7566
Mailing Address - Street 1:37412 N DREAM ST
Mailing Address - Street 2:P.O.BOX 2800-395
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377
Mailing Address - Country:US
Mailing Address - Phone:480-664-7566
Mailing Address - Fax:480-664-7195
Practice Address - Street 1:37412 N DREAM STREET
Practice Address - Street 2:
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377
Practice Address - Country:US
Practice Address - Phone:480-664-7566
Practice Address - Fax:480-664-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home