Organization
DREAM GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORINE NZOFANG (PROGRAM MANAGER)
(508) 215-6186
Entity
Organization
Contact information
Practice address
5524 HAUN DR, FORT WORTH, TX 76137-3758
(508) 215-6186
Mailing address
5524 HAUN DR, FORT WORTH, TX 76137-3758
(508) 215-6186
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
05/16/2026
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