Dreams of Maiposa LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

DREAMS OF MAIPOSA LLC

Practice address

4693 Clarks Creek LN
Ellenwood, GA 30294-6564

Phone

(770) 574-6268

NPI assigned

Jan 10, 2023

Last updated

Jan 10, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Regina Harris

Title

Excutive Director

Phone

(556) 817-0049

Specialties & licenses 5

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1093429540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 TARA BLVD STE PMB 1074",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4693 CLARKS CREEK LN",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946564",
            "telephone_number": "770-574-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMS OF MAIPOSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "556-817-0049"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.