Provider Demographics
NPI:1336663582
Name:DIOGI HEALTH & WELLNESS CENTER
Entity Type:Organization
Organization Name:DIOGI HEALTH & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, DCFMSW, CAP, S
Authorized Official - Phone:561-281-8233
Mailing Address - Street 1:8552 THOUSAND PINES CIR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1904
Mailing Address - Country:US
Mailing Address - Phone:561-281-8233
Mailing Address - Fax:561-790-2535
Practice Address - Street 1:8552 THOUSAND PINES CIR
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1904
Practice Address - Country:US
Practice Address - Phone:561-281-8233
Practice Address - Fax:561-790-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW88351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251619701667-001Other1174897052
FL1174897052Other251619701667-001