Provider Demographics
NPI:1699253807
Name:DIAMOND HOME HEALTH CARE SERVICES
Entity type:Organization
Organization Name:DIAMOND HOME HEALTH CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING ASSISTANT
Authorized Official - Phone:917-595-7569
Mailing Address - Street 1:4949 WESTON PKWY STE 165
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:917-595-7569
Mailing Address - Fax:
Practice Address - Street 1:4949 WESTON PKWY STE 165 #836
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:917-595-7569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343744771015E251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health