Organization
DREAMS OF MAIPOSA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA HARRIS (EXCUTIVE DIRECTOR)
(556) 817-0049
Entity
Organization
Contact information
Practice address
4693 CLARKS CREEK LN, ELLENWOOD, GA 30294-6564
(770) 574-6268
Mailing address
6525 TARA BLVD STE PMB 1074, JONESBORO, GA 30236-1227
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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