Provider Demographics
NPI:1821628603
Name:DIVERSIFIED HEALTHCARE, INC.
Entity Type:Organization
Organization Name:DIVERSIFIED HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NNANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-464-8759
Mailing Address - Street 1:105 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5634
Mailing Address - Country:US
Mailing Address - Phone:919-989-8015
Mailing Address - Fax:919-989-8015
Practice Address - Street 1:105 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-5634
Practice Address - Country:US
Practice Address - Phone:919-989-8015
Practice Address - Fax:919-989-8015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care