Provider Demographics
NPI:1962000398
Name:DIVERSITY MANAGEMENT ENTERPRISES LLC
Entity Type:Organization
Organization Name:DIVERSITY MANAGEMENT ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, QMHP-A/C
Authorized Official - Phone:757-600-4140
Mailing Address - Street 1:1005 TRUMAN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-3634
Mailing Address - Country:US
Mailing Address - Phone:757-600-4140
Mailing Address - Fax:650-410-7218
Practice Address - Street 1:1005 TRUMAN RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-3634
Practice Address - Country:US
Practice Address - Phone:757-600-4140
Practice Address - Fax:650-410-7218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)