Healthcare Provider Details

I. General information

NPI: 1902330632
Provider Name (Legal Business Name): DIAMONDS OF MY HEART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11884 E 10 MILE RD
WARREN MI
48089-3901
US

IV. Provider business mailing address

20410 TERRELL ST
DETROIT MI
48234-3209
US

V. Phone/Fax

Practice location:
  • Phone: 586-745-1752
  • Fax:
Mailing address:
  • Phone: 586-745-1752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateMI

VIII. Authorized Official

Name: JENNIFER CURTIS
Title or Position: OWNER
Credential:
Phone: 586-745-1752