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Organization

DREAM BIG 1 CONTINUUM OF CARE

Active
Parent organization
DREAM BIG 1 LLC
Other names
Dream Big 1 Continuum of Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
DREAM BIG 1 LLC
Authorized official
LATASHA CARR LPC, JD (PRESIDENT/OWNER)
(252) 470-7236
Entity
Organization

Contact information

Practice address
100 E PENN SQ STE 400, PHILADELPHIA, PA 19107-3310
(267) 857-9734
(909) 443-9497
Mailing address
2105 PRESBYTERIAN LN # 1002, KINSTON, NC 28501-2265
(252) 470-7236

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
251S00000X
Community/Behavioral Health Agency
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QP2400X
Prison Health Clinic/Center
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1039891100001
PA
Enumeration date
01/08/2024
Last updated
01/08/2024
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