Provider Demographics
NPI:1427324367
Name:DREAM TEAM OF LA, INC.
Entity type:Organization
Organization Name:DREAM TEAM OF LA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-340-3958
Mailing Address - Street 1:3801 N. CAUSEWAY BLVE
Mailing Address - Street 2:STE 301
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-304-5780
Mailing Address - Fax:504-304-5787
Practice Address - Street 1:3801 N. CAUSEWAY BLVE
Practice Address - Street 2:STE 301
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002
Practice Address - Country:US
Practice Address - Phone:504-304-5780
Practice Address - Fax:504-304-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 15317251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health