Provider Demographics
NPI:1588413991
Name:DREAM STREET GROUP HOMES LLC.
Entity type:Organization
Organization Name:DREAM STREET GROUP HOMES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PECINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-245-2600
Mailing Address - Street 1:13547 W PECK DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5318
Mailing Address - Country:US
Mailing Address - Phone:602-245-2600
Mailing Address - Fax:
Practice Address - Street 1:4820 S 111TH AVE
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-4575
Practice Address - Country:US
Practice Address - Phone:602-816-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness