Provider Demographics
NPI:1063761575
Name:DIAMOND MANAGEMENT & STAFFING CORPORATION
Entity type:Organization
Organization Name:DIAMOND MANAGEMENT & STAFFING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-213-4505
Mailing Address - Street 1:19111 W 10 MILE RD
Mailing Address - Street 2:SUITE 231
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2417
Mailing Address - Country:US
Mailing Address - Phone:248-213-4505
Mailing Address - Fax:
Practice Address - Street 1:19111 W 10 MILE RD.
Practice Address - Street 2:SUITE 231
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2443
Practice Address - Country:US
Practice Address - Phone:248-213-4505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5183351Medicaid
5847460001Medicare NSC