Provider Demographics
NPI:1427111384
Name:DREAM MAKERS ASSISTED LIVING SERVICES, LLC..
Entity type:Organization
Organization Name:DREAM MAKERS ASSISTED LIVING SERVICES, LLC..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:WINFRED
Authorized Official - Last Name:TRANSOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-300-0370
Mailing Address - Street 1:6 W HEMSTEAD ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-2696
Mailing Address - Country:US
Mailing Address - Phone:336-300-0370
Mailing Address - Fax:336-464-2225
Practice Address - Street 1:4265 BROWNSBORO RD
Practice Address - Street 2:SUITE 206
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3425
Practice Address - Country:US
Practice Address - Phone:336-300-0370
Practice Address - Fax:336-464-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409687Medicaid