Provider Demographics
NPI:1528526662
Name:ALL AMERICAN DREAM ASSISTED LIVING FACILITY, LLC
Entity type:Organization
Organization Name:ALL AMERICAN DREAM ASSISTED LIVING FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEMOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLATUNJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-278-0179
Mailing Address - Street 1:809 RODNEY AVE
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-2438
Mailing Address - Country:US
Mailing Address - Phone:254-577-5547
Mailing Address - Fax:254-577-5528
Practice Address - Street 1:809 RODNEY AVE
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-2438
Practice Address - Country:US
Practice Address - Phone:254-577-5547
Practice Address - Fax:254-577-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility