Provider Demographics
NPI:1508564600
Name:DIAMOND LUX ENTERPRISES LLC
Entity Type:Organization
Organization Name:DIAMOND LUX ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-773-4599
Mailing Address - Street 1:6102 79TH ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8714
Mailing Address - Country:US
Mailing Address - Phone:806-773-4599
Mailing Address - Fax:
Practice Address - Street 1:6102 79TH ST UNIT B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-8714
Practice Address - Country:US
Practice Address - Phone:806-773-4599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility