Provider Demographics
NPI:1467286625
Name:MVJ DIAMOND CARE LLC
Entity type:Organization
Organization Name:MVJ DIAMOND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONDREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-534-2923
Mailing Address - Street 1:1400 HOOPER AVENUE 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:732-347-7478
Mailing Address - Fax:
Practice Address - Street 1:1400 HOOPER AVENUE 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-347-7478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care