Provider Demographics
NPI:1861128860
Name:AMERICANS DREAM HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:AMERICANS DREAM HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIE SAINT JOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-324-6799
Mailing Address - Street 1:12888 PASTURES WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7634
Mailing Address - Country:US
Mailing Address - Phone:239-324-6799
Mailing Address - Fax:239-324-6799
Practice Address - Street 1:3049 CLEVELAND AVE STE 243
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7046
Practice Address - Country:US
Practice Address - Phone:239-324-6799
Practice Address - Fax:239-324-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty