Provider Demographics
NPI:1588233969
Name:DIAMOND CARE GROUP INC
Entity Type:Organization
Organization Name:DIAMOND CARE GROUP INC
Other - Org Name:EMERALD HOSPICE AND LIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICKSON
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:BAUTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-550-3633
Mailing Address - Street 1:1500 E TROPICANA AVE STE 127
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-8313
Mailing Address - Country:US
Mailing Address - Phone:877-505-6828
Mailing Address - Fax:877-550-3633
Practice Address - Street 1:1500 E TROPICANA AVE STE 127
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-8313
Practice Address - Country:US
Practice Address - Phone:877-505-6828
Practice Address - Fax:877-550-3633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based