# DIVERSE DREAMS LLC

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

## Provider details

- **NPI number:** 1801788096
- **Authorized official:** TINA EZEH (CEO)
- **Authorized official phone:** (706) 883-5885

## Contact information

- **Practice address:** 2959 CHAPEL HILL RD STE D1185, DOUGLASVILLE, GA 30135-1785
- **Practice address phone:** (706) 883-5885
- **Mailing address:** 5945 AZALEA RIDGE DR, DOUGLASVILLE, GA 30135-5590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2025
- **Last updated:** 07/21/2025