Provider Demographics
NPI:1750075024
Name:DREAM 4 DEJAH, LLC
Entity type:Organization
Organization Name:DREAM 4 DEJAH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALCOHOL AND DRUG COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SITUMBA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:CADC II
Authorized Official - Phone:888-226-1333
Mailing Address - Street 1:6187 ATLANTIC AVE
Mailing Address - Street 2:#2059
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2922
Mailing Address - Country:US
Mailing Address - Phone:888-226-1333
Mailing Address - Fax:562-286-8296
Practice Address - Street 1:535 E ADAMS ST APT 4
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2353
Practice Address - Country:US
Practice Address - Phone:888-226-1333
Practice Address - Fax:562-286-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children