Provider Demographics
NPI:1558186585
Name:THE DIAMOND OF HOME CARE LLC
Entity type:Organization
Organization Name:THE DIAMOND OF HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANN
Authorized Official - Middle Name:ALECIA
Authorized Official - Last Name:DOOLING
Authorized Official - Suffix:
Authorized Official - Credentials:CCMA, CMA, CPT, CNA
Authorized Official - Phone:943-226-7125
Mailing Address - Street 1:889 COMMERCE DR SW STE C
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6624
Mailing Address - Country:US
Mailing Address - Phone:943-226-7125
Mailing Address - Fax:
Practice Address - Street 1:889 COMMERCE DR SW STE C
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6624
Practice Address - Country:US
Practice Address - Phone:943-226-7125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness