Provider Demographics
NPI:1134569601
Name:DIVERSIFIED CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:DIVERSIFIED CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DORESEA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-502-7308
Mailing Address - Street 1:310 JOHN R RD STE 173
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4542
Mailing Address - Country:US
Mailing Address - Phone:248-935-6161
Mailing Address - Fax:248-236-8471
Practice Address - Street 1:318 JOHN R RD STE 173
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-4542
Practice Address - Country:US
Practice Address - Phone:248-935-6161
Practice Address - Fax:248-236-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health