Provider Demographics
NPI:1992923940
Name:DIVERSIFIED HUMAN SERVICES, INC.
Entity type:Organization
Organization Name:DIVERSIFIED HUMAN SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-489-9100
Mailing Address - Street 1:301 CHAMBER PLAZA
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1607
Mailing Address - Country:US
Mailing Address - Phone:724-489-8096
Mailing Address - Fax:724-483-9373
Practice Address - Street 1:301 CHAMBER PLAZA
Practice Address - Street 2:
Practice Address - City:CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-1607
Practice Address - Country:US
Practice Address - Phone:724-489-8096
Practice Address - Fax:724-483-9373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWESTERN PENNSYLVANIA HUMAN SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-23
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000519E225100000X
PASL003433L235Z00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000016190066Medicaid