Provider Demographics
NPI:1013734078
Name:DIANA & DEER ASSISTANCE LIVING AND AGENCY
Entity type:Organization
Organization Name:DIANA & DEER ASSISTANCE LIVING AND AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLIN BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-292-8255
Mailing Address - Street 1:139 MOUNT PLEASANT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5612
Mailing Address - Country:US
Mailing Address - Phone:508-292-8255
Mailing Address - Fax:
Practice Address - Street 1:139 MOUNT PLEASANT ST APT 1
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5612
Practice Address - Country:US
Practice Address - Phone:508-292-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health