Provider Demographics
NPI:1699595454
Name:COLLEGE DREAMS, INC
Entity type:Organization
Organization Name:COLLEGE DREAMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE& ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-476-8146
Mailing Address - Street 1:789 NE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1632
Mailing Address - Country:US
Mailing Address - Phone:541-476-8146
Mailing Address - Fax:
Practice Address - Street 1:789 NE 7TH ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1632
Practice Address - Country:US
Practice Address - Phone:541-476-8146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLCARE CCO, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty