Provider Demographics
NPI:1144042201
Name:DIAMOND SENIOR CARE SERVICES, LLC
Entity type:Organization
Organization Name:DIAMOND SENIOR CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:MA CONSEJO
Authorized Official - Middle Name:
Authorized Official - Last Name:PABLICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-563-0402
Mailing Address - Street 1:8827 JONQIL DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2482
Mailing Address - Country:US
Mailing Address - Phone:561-563-0402
Mailing Address - Fax:
Practice Address - Street 1:8210 SUMMER LAKE PASS LN
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-1851
Practice Address - Country:US
Practice Address - Phone:561-563-0402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)