Dreamshine at Autumn Lakes LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

DREAMSHINE AT AUTUMN LAKES LLC

Practice address

3821 Blue Church Rd
Sunbury, OH 43074-8922

Phone

(614) 226-9105

NPI assigned

Apr 19, 2012

Last updated

Apr 19, 2012By 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

Ms. Amy E Minard

Title

Administrator

Phone

(614) 226-9105

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1265799829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 BLUE CHURCH RD",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430748922",
            "telephone_number": "614-226-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 BLUE CHURCH RD",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430748922",
            "telephone_number": "614-226-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMSHINE AT AUTUMN LAKES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "MINARD",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "614-226-9105",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2727115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian A Dittenber, O.D.
• Kristen A Dolcich, PT
• Sandra Donatelli
• Kristen Alice Donnelly
• Kelly A Dotson
• Anthony Eckert, DC
• Aaron Elliott Erndt, D.C
• Thomas W Erndt, D.C.
• Laurie Erpenbeck, OD
• Joan Ellen Evans, HOME CARE PROVIDER

• Developmentally Disabled Services Day Training Agency in Sunbury, OH
• Providers in Sunbury, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.