Provider Demographics
NPI:1326725573
Name:DIAMOND SENIOR LIVING
Entity Type:Organization
Organization Name:DIAMOND SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:FELICIANO
Authorized Official - Last Name:DELAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-355-3166
Mailing Address - Street 1:2311 ROSWELL AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1718
Mailing Address - Country:US
Mailing Address - Phone:562-355-3166
Mailing Address - Fax:
Practice Address - Street 1:2311 ROSWELL AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1718
Practice Address - Country:US
Practice Address - Phone:562-355-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility