Provider Demographics
NPI:1366019457
Name:DIAMOND HEALTH SERVICES CORP
Entity Type:Organization
Organization Name:DIAMOND HEALTH SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISIR
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-636-1983
Mailing Address - Street 1:3037 2ND AVE S STE 101
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2401
Mailing Address - Country:US
Mailing Address - Phone:612-636-1983
Mailing Address - Fax:
Practice Address - Street 1:3037 2ND AVE S STE 101
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2401
Practice Address - Country:US
Practice Address - Phone:612-636-1983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health