Provider Demographics
NPI:1790566610
Name:DIAMOND HOME CARE LLC
Entity Type:Organization
Organization Name:DIAMOND HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOE
Authorized Official - Middle Name:THA
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-371-7879
Mailing Address - Street 1:2416 GERRARD AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-5044
Mailing Address - Country:US
Mailing Address - Phone:480-371-7879
Mailing Address - Fax:
Practice Address - Street 1:2416 GERRARD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-5044
Practice Address - Country:US
Practice Address - Phone:480-371-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care