Organization
DREAM HOME PROFESSIONAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DAVIS (OWNER)
(940) 631-4405
Entity
Organization
Contact information
Practice address
312 GENTLE STREAM LN, RALEIGH, NC 27603-4868
(940) 631-4405
Mailing address
312 GENTLE STREAM LN, RALEIGH, NC 27603-4868
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251T00000X
PACE Provider Organization
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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