Provider Demographics
NPI:1235429135
Name:DIAMOND CARE, L.L.C
Entity Type:Organization
Organization Name:DIAMOND CARE, L.L.C
Other - Org Name:DIAMOND HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:ILO
Authorized Official - Last Name:TAISAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-235-2274
Mailing Address - Street 1:P.O. BOX 500633
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-235-2274
Mailing Address - Fax:670-235-2275
Practice Address - Street 1:PALE ARNOLD ROAD/MIDDLE ROAD, GUAIO RAI
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-235-2274
Practice Address - Fax:670-235-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP19661-0001-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health