Provider Demographics
NPI:1073988408
Name:DIAMOND SENIOR SERVICES
Entity Type:Organization
Organization Name:DIAMOND SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-612-1388
Mailing Address - Street 1:5522 NEW PEACHTREE RD
Mailing Address - Street 2:SUITE 122
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2543
Mailing Address - Country:US
Mailing Address - Phone:770-612-1388
Mailing Address - Fax:
Practice Address - Street 1:5522 NEW PEACHTREE RD
Practice Address - Street 2:SUITE 122
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-2543
Practice Address - Country:US
Practice Address - Phone:770-612-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care