Provider Demographics
NPI:1902160641
Name:DREAMERS HOME HEALTH CARE (LLC)
Entity Type:Organization
Organization Name:DREAMERS HOME HEALTH CARE (LLC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:CELESTINE
Authorized Official - Last Name:KORVAH
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, MPH
Authorized Official - Phone:614-354-4348
Mailing Address - Street 1:922 EASTWIND DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3329
Mailing Address - Country:US
Mailing Address - Phone:614-895-0267
Mailing Address - Fax:614-895-0801
Practice Address - Street 1:922 EASTWIND DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-895-0267
Practice Address - Fax:614-895-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0096529Medicaid