Provider Demographics
NPI:1861289530
Name:BLUE DIAMOND HOLDINGS LLC
Entity type:Organization
Organization Name:BLUE DIAMOND HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-242-9073
Mailing Address - Street 1:8153 LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3321
Mailing Address - Country:US
Mailing Address - Phone:773-242-9073
Mailing Address - Fax:
Practice Address - Street 1:8153 LAWNDALE AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3321
Practice Address - Country:US
Practice Address - Phone:773-242-9073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUE DIAMOND HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-24
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities