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NPI Code Detail

MEDICARE: DIAMOND HOME CARE LLC

MEDICARE: DIAMOND HOME CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1790566610
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAMOND HOME CARE LLC
Provider Business Mailing Address
First Line : 2416 GERRARD AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46224-5044
Country : US
Telephone Number : 480-371-7879
Fax Number :
Provider Business Practice Location Address
First Line : 2416 GERRARD AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46224-5044
Country : US
Telephone Number : 480-371-7879
Fax Number :
Authorized Official
Title or Position : OWNER
Name : YOE THA DIAMOND
Credential :
Telephone Number : 480-371-7879
Provider Enumeration Date : 10/06/2023
Last Update Date : 10/06/2023

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Directions to “DIAMOND HOME CARE LLC ” Practice Location

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