# 1121 DREAM HOME

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

## Provider details

- **NPI number:** 1043921109
- **Authorized official:** LESTIA NELSON (FOUNDER)
- **Authorized official phone:** (678) 592-9861

## Contact information

- **Practice address:** 4113 BLEVINS LN, PLANO, TX 75074
- **Practice address phone:** (214) 807-7006
- **Mailing address:** 4113 BLEVINS LN, PLANO, TX 75074
- **Mailing address phone:** (678) 592-9861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 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