Provider Demographics
NPI:1285434811
Name:DIAMOND DREAMERS
Entity type:Organization
Organization Name:DIAMOND DREAMERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIABEHTI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:BSHM
Authorized Official - Phone:732-881-2150
Mailing Address - Street 1:35 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1961
Mailing Address - Country:US
Mailing Address - Phone:732-881-2150
Mailing Address - Fax:
Practice Address - Street 1:901 GREEN HILL MANOR DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-2617
Practice Address - Country:US
Practice Address - Phone:732-880-8083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health