# DREAMS OF MAIPOSA LLC

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

## Provider details

- **NPI number:** 1093429540
- **Authorized official:** REGINA HARRIS (EXCUTIVE DIRECTOR)
- **Authorized official phone:** (556) 817-0049

## Contact information

- **Practice address:** 4693 CLARKS CREEK LN, ELLENWOOD, GA 30294-6564
- **Practice address phone:** (770) 574-6268
- **Mailing address:** 6525 TARA BLVD STE PMB 1074, JONESBORO, GA 30236-1227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174200000X | Meals Provider | — | — | — |
| 251E00000X | Home Health Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |
| 332U00000X | Home Delivered Meals | — | — | — |
| 385H00000X | Respite Care | — | — | — |

## Other

- **Enumeration date:** 01/10/2023
- **Last updated:** 01/10/2023