Provider Demographics
NPI:1346579810
Name:DIAMOND HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:DIAMOND HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-379-1008
Mailing Address - Street 1:209 ELDEN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4847
Mailing Address - Country:US
Mailing Address - Phone:703-379-1008
Mailing Address - Fax:703-379-0844
Practice Address - Street 1:209 ELDEN ST STE 307
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4847
Practice Address - Country:US
Practice Address - Phone:703-981-3474
Practice Address - Fax:866-470-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-13
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497699OtherPTAN