Provider Demographics
NPI:1265568596
Name:DIA-TECH SERVICES LLC
Entity type:Organization
Organization Name:DIA-TECH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZZSET
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-266-6812
Mailing Address - Street 1:3923 WINNEBAGO ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-5958
Mailing Address - Country:US
Mailing Address - Phone:225-266-6812
Mailing Address - Fax:
Practice Address - Street 1:3923 WINNEBAGO ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-5958
Practice Address - Country:US
Practice Address - Phone:225-266-6812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA223948168OtherLACARE
LA223948168OtherAETNA
LA223948168OtherTRICARE
LA223948168OtherUNITED HEALTHCARE
LA223948168OtherOFFICE OF RISK MANAGEMENT
LA223948168OtherLOUISIANA HEALTHCARE CONNECTIONS
LAH7520OtherBLUECROSS/BLUESHIELD OF LOUISIANA
LA223948168OtherAMERIGROUP COMMUNITY CARE
LA=========OtherAETNA
LA=========OtherOFFICE OF RISK MANAGEMENT
LA5032213OtherCOVENTRY HEALTHCARE
LA=========OtherUNITED HEALTHCARE
LA=========OtherAMERIGROUP COMMUNITY CARE
LA1407836Medicaid
LA=========OtherFEMA
LA=========OtherMULTIPLAN
LA1407836Medicaid