Provider Demographics
NPI:1770529570
Name:DIAMOND HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:DIAMOND HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:248-249-9595
Mailing Address - Street 1:851 PENNIMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1621
Mailing Address - Country:US
Mailing Address - Phone:248-349-9595
Mailing Address - Fax:248-349-7962
Practice Address - Street 1:851 PENNIMAN AVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1621
Practice Address - Country:US
Practice Address - Phone:248-349-9595
Practice Address - Fax:248-349-7962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237529251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237529Medicare ID - Type UnspecifiedHOME HEALTH CARE