Provider Demographics
NPI:1003374992
Name:DIAMOND HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:DIAMOND HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-643-8048
Mailing Address - Street 1:1940 RUNAWAY BAY LN APT F
Mailing Address - Street 2:
Mailing Address - City:SPEEDWAY
Mailing Address - State:IN
Mailing Address - Zip Code:46224-8862
Mailing Address - Country:US
Mailing Address - Phone:317-643-8048
Mailing Address - Fax:317-643-2708
Practice Address - Street 1:1940 RUNAWAY BAY LN APT F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-8862
Practice Address - Country:US
Practice Address - Phone:317-643-8048
Practice Address - Fax:317-643-2708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-09
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care