Provider Demographics
NPI:1275155780
Name:DIAMOND CARE COMPANION AGENCY INC.
Entity Type:Organization
Organization Name:DIAMOND CARE COMPANION AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO /OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUROKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-560-6889
Mailing Address - Street 1:7 LATTICE CT
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-1901
Mailing Address - Country:US
Mailing Address - Phone:631-345-5674
Mailing Address - Fax:
Practice Address - Street 1:7 LATTICE CT
Practice Address - Street 2:
Practice Address - City:RIDGE
Practice Address - State:NY
Practice Address - Zip Code:11961-1901
Practice Address - Country:US
Practice Address - Phone:631-345-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty