Organization
DREAMS '2' REALITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES SMITH QP (CEO)
(704) 968-6049
Entity
Organization
Contact information
Practice address
1551 MOORE DR, GASTONIA, NC 28054-5533
(704) 864-8561
(704) 947-0815
Mailing address
1551 MOORE DR, GASTONIA, NC 28054-5533
(704) 864-8561
(704) 947-0815
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-036154
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322D00000X
—
NC
Enumeration date
01/09/2007
Last updated
08/22/2020
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