Provider Demographics
NPI:1285091868
Name:DIVERSITY HEALTHCARE CONNECTIONS LLC
Entity type:Organization
Organization Name:DIVERSITY HEALTHCARE CONNECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DJWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-452-3279
Mailing Address - Street 1:330 BOSTON RD
Mailing Address - Street 2:UNIT 5
Mailing Address - City:NORTH BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862-2300
Mailing Address - Country:US
Mailing Address - Phone:978-452-3279
Mailing Address - Fax:
Practice Address - Street 1:330 BOSTON RD
Practice Address - Street 2:UNIT 5
Practice Address - City:NORTH BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862-2300
Practice Address - Country:US
Practice Address - Phone:978-452-3279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health