Healthcare Provider Details

I. General information

NPI: 1811741564
Provider Name (Legal Business Name): DIAMOND HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CENTRAL AVE STE 501
LYNN MA
01901-1201
US

IV. Provider business mailing address

20 CENTRAL AVE STE 501
LYNN MA
01901-1201
US

V. Phone/Fax

Practice location:
  • Phone: 781-268-0001
  • Fax: 213-867-8221
Mailing address:
  • Phone: 781-268-0001
  • Fax: 213-867-8221

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CARLOS DE LOS SANTOS
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 781-268-0001