Provider Demographics
NPI:1356851596
Name:DIAMONDS ENTERPRISE HEALTH SERVICES,LLC
Entity Type:Organization
Organization Name:DIAMONDS ENTERPRISE HEALTH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ALT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARREY
Authorized Official - Middle Name:STEVONE
Authorized Official - Last Name:MBU AYANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-217-6728
Mailing Address - Street 1:2221 PENINSULA DR STE 209
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2954
Mailing Address - Country:US
Mailing Address - Phone:814-217-6728
Mailing Address - Fax:814-217-1550
Practice Address - Street 1:2221 PENINSULA DR # 209
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2954
Practice Address - Country:US
Practice Address - Phone:814-217-6728
Practice Address - Fax:814-217-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No251X00000XAgenciesSupports BrokerageGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child