Provider Demographics
NPI:1609249523
Name:DIAMOND HOSPICE SERVICES INC.
Entity Type:Organization
Organization Name:DIAMOND HOSPICE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPCS
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:310-817-5665
Mailing Address - Street 1:18411 CRENSHAW BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5078
Mailing Address - Country:US
Mailing Address - Phone:310-817-5665
Mailing Address - Fax:310-816-5539
Practice Address - Street 1:18411 CRENSHAW BLVD STE 110
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-5078
Practice Address - Country:US
Practice Address - Phone:310-817-5665
Practice Address - Fax:310-816-5539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based