Provider Demographics
NPI:1427378116
Name:DIVERSITY HOME AND HEALTH SERVICES LLC.
Entity Type:Organization
Organization Name:DIVERSITY HOME AND HEALTH SERVICES LLC.
Other - Org Name:DIVERSITY HOME AND HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAMMILL
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:830-563-2700
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:BRACKETTVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78832-0312
Mailing Address - Country:US
Mailing Address - Phone:830-563-2700
Mailing Address - Fax:830-563-2701
Practice Address - Street 1:104 E MILITARY
Practice Address - Street 2:REAR
Practice Address - City:BRACKETTVILLE
Practice Address - State:TX
Practice Address - Zip Code:78832
Practice Address - Country:US
Practice Address - Phone:830-563-2700
Practice Address - Fax:830-563-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health