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Organization
DREAM ALIVE LLC
Active
Organization
DREAM ALIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINA A THEIL (OWNER)
(480) 652-0718
Entity
Organization
Contact information
Practice address
12521 W CORRINE DR, EL MIRAGE, AZ 85335-6213
(480) 652-0718
Mailing address
12521 W CORRINE DR, EL MIRAGE, AZ 85335-6213
(480) 652-0718
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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