Organization
DREAM TEAM GROUP HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CYNTHIA GAY (OWNER AND DIRECTOR)
(305) 609-1258
Entity
Organization
Contact information
Practice address
3653 NW 4TH TER, MIAMI, FL 33125-4073
(305) 609-1258
(866) 490-1272
Mailing address
3653 NW 4TH TER, MIAMI, FL 33125-4073
(305) 609-1258
(866) 490-1272
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
11-954-GH
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003237800
—
FL
Enumeration date
11/17/2014
Last updated
11/17/2014
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