Provider Demographics
NPI:1790243574
Name:BLUE DIAMOND CARE
Entity Type:Organization
Organization Name:BLUE DIAMOND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNATED MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-915-7504
Mailing Address - Street 1:4218 ROANOKE RD STE 346
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3198
Mailing Address - Country:US
Mailing Address - Phone:816-298-0205
Mailing Address - Fax:816-298-0205
Practice Address - Street 1:4218 ROANOKE RD STE 346
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3198
Practice Address - Country:US
Practice Address - Phone:816-298-0205
Practice Address - Fax:816-298-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty