The Dream House for Medically Fragile Children, Inc.

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

067R0725 Issued in GA

Legal business name

THE DREAM HOUSE FOR MEDICALLY FRAGILE CHILDREN, INC.

Practice address

4896 Miller Rd SW
Lilburn, GA 30047-5333

Phone

(770) 806-1621

Fax

(678) 990-9812

NPI assigned

Jul 29, 2010

Organization subpart

No

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

Authorized official

Name

Kim Marks

Title

Chief Program Officer

Phone

(770) 717-7410

Specialties & licenses 11

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1649584939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2092 SCENIC HWY N",
            "address_2": "SUITE B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786188",
            "telephone_number": "770-717-7410",
            "fax_number": "770-923-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4896 MILLER RD SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300475333",
            "telephone_number": "770-806-1621",
            "fax_number": "678-990-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DREAM HOUSE FOR MEDICALLY FRAGILE CHILDREN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "770-717-7410"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "067R0725",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "067R0725",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "067R0725",
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "GA",
            "license": "067R0725",
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "GA",
            "license": "067R0725",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "GA",
            "license": "CTCC001001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MEDICAID/PEACH CARE FOR KIDS",
            "identifier": "513959537A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.