Provider Demographics
NPI:1194322024
Name:DAY DREAM HOME CARE
Entity type:Organization
Organization Name:DAY DREAM HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CILLIAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-525-7149
Mailing Address - Street 1:PO BOX 616145
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6145
Mailing Address - Country:US
Mailing Address - Phone:904-525-7149
Mailing Address - Fax:
Practice Address - Street 1:501 SOUTH KIRKMAN ROAD 616145
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32861-3286
Practice Address - Country:US
Practice Address - Phone:904-525-7149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372600000XOtherADULT COMPANION
FL376J00000XOtherHOMEMAKER & COMPANION