Provider Demographics
NPI:1740352822
Name:THE DREAM WORKS, INC.
Entity type:Organization
Organization Name:THE DREAM WORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-281-8695
Mailing Address - Street 1:1119 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-2305
Mailing Address - Country:US
Mailing Address - Phone:913-281-8695
Mailing Address - Fax:913-281-8699
Practice Address - Street 1:1119 N 5TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-2305
Practice Address - Country:US
Practice Address - Phone:913-281-8695
Practice Address - Fax:913-281-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA105034251E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO858639800Medicaid
KS100310610EMedicaid
MO626151609Medicaid
MO858639800Medicaid