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Organization
1121 DREAM HOME
Active
Organization
1121 DREAM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESTIA NELSON (FOUNDER)
(678) 592-9861
Entity
Organization
Contact information
Practice address
4113 BLEVINS LN, PLANO, TX 75074
(214) 807-7006
Mailing address
4113 BLEVINS LN, PLANO, TX 75074
(678) 592-9861
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
310400000X
Assisted Living Facility
—
NULL
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
385HR2065X
Child Physical Disabilities Respite Care
—
NULL
Other
Enumeration date
12/09/2022
Last updated
12/03/2025
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