Provider Demographics
NPI:1902659956
Name:MARVELOUS DREAM SERVICES INC
Entity Type:Organization
Organization Name:MARVELOUS DREAM SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREYSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTIEL PLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-447-3228
Mailing Address - Street 1:17922 SW 156TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1741
Mailing Address - Country:US
Mailing Address - Phone:786-447-3228
Mailing Address - Fax:
Practice Address - Street 1:13550 SW 88TH ST STE 270B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1513
Practice Address - Country:US
Practice Address - Phone:786-447-3228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty