Provider Demographics
NPI:1477379113
Name:DREAMLAND HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:DREAMLAND HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHIEDOZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANOKWUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-930-1586
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-0026
Mailing Address - Country:US
Mailing Address - Phone:317-930-1586
Mailing Address - Fax:
Practice Address - Street 1:9240 N MERIDIAN ST STE 310
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1822
Practice Address - Country:US
Practice Address - Phone:317-930-1586
Practice Address - Fax:463-777-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty