Provider Demographics
NPI:1386763597
Name:THE DREAM WORKS, INC
Entity type:Organization
Organization Name:THE DREAM WORKS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCINNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-897-3415
Mailing Address - Street 1:4240 BLUE RIDGE BLVD
Mailing Address - Street 2:STE.321
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-1713
Mailing Address - Country:US
Mailing Address - Phone:816-897-3415
Mailing Address - Fax:816-895-9330
Practice Address - Street 1:4240 BLUE RIDGE BLVD
Practice Address - Street 2:STE.321
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1713
Practice Address - Country:US
Practice Address - Phone:816-897-3415
Practice Address - Fax:816-895-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO858639800251C00000X, 251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO858639800Medicaid