# DREAM HAVEN EXTENSIONS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023945136
- **Authorized official:** DREAM HAVEN EXTENSIONS (MANAGER)
- **Authorized official phone:** (214) 635-6412

## Contact information

- **Practice address:** 4500 MERCANTILE PLAZA DR \# 17147172, FORT WORTH, TX 76137-4225
- **Practice address phone:** (214) 635-6412
- **Mailing address:** 4500 MERCANTILE PLAZA DR \# 17147172, FORT WORTH, TX 76137-4225
- **Mailing address phone:** (214) 635-6412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2026
- **Last updated:** 05/05/2026