Provider Demographics
NPI:1689496242
Name:DREAM TEAM OF LA, INC
Entity type:Organization
Organization Name:DREAM TEAM OF LA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-340-3958
Mailing Address - Street 1:1206 J W DAVIS DR STE 106
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5953
Mailing Address - Country:US
Mailing Address - Phone:985-340-3958
Mailing Address - Fax:985-340-3961
Practice Address - Street 1:1206 J W DAVIS DR STE 106
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5953
Practice Address - Country:US
Practice Address - Phone:985-340-3958
Practice Address - Fax:985-340-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care