Provider Demographics
NPI:1699385799
Name:DIANA CARE SERVICES
Entity Type:Organization
Organization Name:DIANA CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GAI
Authorized Official - Middle Name:D
Authorized Official - Last Name:TARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-298-7836
Mailing Address - Street 1:55 NEW ST STE 7
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2826
Mailing Address - Country:US
Mailing Address - Phone:267-648-6662
Mailing Address - Fax:
Practice Address - Street 1:55 NEW ST STE 7
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2826
Practice Address - Country:US
Practice Address - Phone:267-648-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1033093770002Medicaid