Provider Demographics
NPI:1104563824
Name:DIAMOND BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:DIAMOND BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHINYERE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIBE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCH-NP
Authorized Official - Phone:202-390-4129
Mailing Address - Street 1:10451 MILL RUN CIR STE 415
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5577
Mailing Address - Country:US
Mailing Address - Phone:202-390-4129
Mailing Address - Fax:240-444-8145
Practice Address - Street 1:516 HILL RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4617
Practice Address - Country:US
Practice Address - Phone:202-390-4129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-14
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)