Provider Demographics
NPI:1902947930
Name:DIAMOND HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:DIAMOND HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:616-241-6670
Mailing Address - Street 1:4829 E BELTLINE AVE NE
Mailing Address - Street 2:SUITE 7C
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9747
Mailing Address - Country:US
Mailing Address - Phone:616-241-6670
Mailing Address - Fax:616-475-9889
Practice Address - Street 1:4829 E BELTLINE AVE NE
Practice Address - Street 2:SUITE 7C
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9747
Practice Address - Country:US
Practice Address - Phone:616-241-6670
Practice Address - Fax:616-475-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
239060Medicare Oscar/Certification