Provider Demographics
NPI:1538507371
Name:DIANA'S HOMECARE, INC.
Entity Type:Organization
Organization Name:DIANA'S HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-456-8389
Mailing Address - Street 1:402 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7856
Mailing Address - Country:US
Mailing Address - Phone:704-456-8389
Mailing Address - Fax:704-256-9957
Practice Address - Street 1:1202 DONCASTLE CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2899
Practice Address - Country:US
Practice Address - Phone:704-456-8389
Practice Address - Fax:704-256-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7806485 MPNMedicaid