1699253807 NPI number — DIAMOND HOME HEALTH CARE SERVICES

Table of content: (NPI 1699253807)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699253807 NPI number — DIAMOND HOME HEALTH CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIAMOND HOME HEALTH CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699253807
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4949 WESTON PKWY STE 165
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-595-7569
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4949 WESTON PKWY STE 165 #836
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-595-7569
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2018

Additional Information

Authorized Official

Authorized Official Last Name:
DIAMOND
Authorized Official First Name:
SARINA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
917-595-7569

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  343744771015E , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com