Provider Demographics
NPI:1194415802
Name:A.E.S DREAMWORKS,LLC
Entity type:Organization
Organization Name:A.E.S DREAMWORKS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAUN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSEBOROUGH-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-425-7917
Mailing Address - Street 1:4904 CHRISTOPHER RUN DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-9506
Mailing Address - Country:US
Mailing Address - Phone:980-425-7917
Mailing Address - Fax:
Practice Address - Street 1:1251 STAFFORD ST UNIT 101
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3349
Practice Address - Country:US
Practice Address - Phone:980-425-7917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251300000XAgenciesLocal Education Agency (LEA)
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No385H00000XRespite Care FacilityRespite Care