Dream Clubhouse Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DREAM CLUBHOUSE INC

Practice address

664 Stratford Blvd
Kinston, NC 28504-9647

Phone

(252) 468-2973

Fax

(855) 717-1947

NPI assigned

Apr 12, 2022

Last updated

Jul 7, 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

Darren Terrell Manning

Title

President

Phone

(252) 550-8609

Specialties & licenses 1

Addresses

Other names 1

• Dream House Other name

Locations

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1417699240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 STRATFORD BLVD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285049647",
            "telephone_number": "252-550-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 STRATFORD BLVD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285049647",
            "telephone_number": "252-468-2973",
            "fax_number": "855-717-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM CLUBHOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-550-8609"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dream House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Kinston, NC
• Providers in Kinston, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.