Healthcare Provider Details

I. General information

NPI: 1861956211
Provider Name (Legal Business Name): DILIGENT SERVICE PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 AUSTIN ST
NEW BRITAIN CT
06051
US

IV. Provider business mailing address

110 AUSTIN ST
NEW BRITAIN CT
06051-2818
US

V. Phone/Fax

Practice location:
  • Phone: 860-712-0831
  • Fax: 888-977-3102
Mailing address:
  • Phone: 860-712-0831
  • Fax: 888-977-3102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. DWAYNE HORATIO JENKINS I
Title or Position: CEO
Credential: CNA
Phone: 860-712-0831