Provider Demographics
NPI:1093723728
Name:DIAMOND HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:DIAMOND HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:DAVIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COUSIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-569-7900
Mailing Address - Street 1:17700 NORTHLAND PARK CT
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4302
Mailing Address - Country:US
Mailing Address - Phone:248-569-7900
Mailing Address - Fax:248-569-7917
Practice Address - Street 1:17700 NORTHLAND PARK CT
Practice Address - Street 2:SUITE 1C
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4302
Practice Address - Country:US
Practice Address - Phone:248-569-7900
Practice Address - Fax:248-569-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI23-7493Medicare ID - Type UnspecifiedHOME CARE AGENCY