Provider Demographics
NPI:1487080784
Name:THE DREAM IN COLOR GROUP
Entity type:Organization
Organization Name:THE DREAM IN COLOR GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:1800-985-7801
Mailing Address - Street 1:2378 E LEDBETTER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7410
Mailing Address - Country:US
Mailing Address - Phone:800-985-7801
Mailing Address - Fax:800-985-7801
Practice Address - Street 1:1700 COMMERCE ST
Practice Address - Street 2:SUITE 660
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-5314
Practice Address - Country:US
Practice Address - Phone:800-985-7801
Practice Address - Fax:800-985-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management