Provider Demographics
NPI:1558033803
Name:ABLE TO DREAM INC
Entity type:Organization
Organization Name:ABLE TO DREAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE-PLEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-890-2449
Mailing Address - Street 1:1375 GATEWAY BLVD STE VO548
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8304
Mailing Address - Country:US
Mailing Address - Phone:305-890-2449
Mailing Address - Fax:844-829-2617
Practice Address - Street 1:1375 GATEWAY BLVD STE VO548
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8304
Practice Address - Country:US
Practice Address - Phone:305-890-2449
Practice Address - Fax:844-829-2617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-04
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104469800Medicaid