Provider Demographics
NPI:1932732211
Name:DIAMOND HEART HOME CARE
Entity Type:Organization
Organization Name:DIAMOND HEART HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADJEI ANTWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-240-5121
Mailing Address - Street 1:1703 W CREEK WAY APT 6
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3929
Mailing Address - Country:US
Mailing Address - Phone:908-240-5121
Mailing Address - Fax:
Practice Address - Street 1:1703 W CREEK WAY APT 6
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242-3929
Practice Address - Country:US
Practice Address - Phone:908-240-5121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care