Provider Demographics
NPI:1801551718
Name:ABC DREAMS
Entity type:Organization
Organization Name:ABC DREAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DERINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-601-8111
Mailing Address - Street 1:2005 SE 192ND AVE # 267
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7475
Mailing Address - Country:US
Mailing Address - Phone:360-601-8111
Mailing Address - Fax:
Practice Address - Street 1:2005 SE 192ND AVE # 267
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7475
Practice Address - Country:US
Practice Address - Phone:360-601-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care