Provider Demographics
NPI:1124708938
Name:DREAMLIFE LLC
Entity type:Organization
Organization Name:DREAMLIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-854-4280
Mailing Address - Street 1:3500 W ROGERS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-4743
Mailing Address - Country:US
Mailing Address - Phone:410-770-2920
Mailing Address - Fax:443-407-1190
Practice Address - Street 1:3500 W ROGERS AVE FL 1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-4743
Practice Address - Country:US
Practice Address - Phone:410-770-2920
Practice Address - Fax:443-407-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health