Provider Demographics
NPI:1588312714
Name:DARE TO DREAM INC
Entity type:Organization
Organization Name:DARE TO DREAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RIDING INSTRUCTOR/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-343-3939
Mailing Address - Street 1:9826 2150 RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:CO
Mailing Address - Zip Code:81410-8345
Mailing Address - Country:US
Mailing Address - Phone:808-343-3939
Mailing Address - Fax:
Practice Address - Street 1:9826 2150 RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:CO
Practice Address - Zip Code:81410-8345
Practice Address - Country:US
Practice Address - Phone:808-343-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty