Provider Demographics
NPI:1699972760
Name:DIVERSIFIED HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:DIVERSIFIED HOME HEALTH AGENCY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PORTIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-624-6232
Mailing Address - Street 1:20401 NW 2ND AVE STE 301A
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2542
Mailing Address - Country:US
Mailing Address - Phone:305-624-6232
Mailing Address - Fax:305-624-0869
Practice Address - Street 1:20401 NW 2ND AVE STE 301A
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2542
Practice Address - Country:US
Practice Address - Phone:305-624-6232
Practice Address - Fax:305-684-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health