Healthcare Provider Details

I. General information

NPI: 1386533750
Provider Name (Legal Business Name): DIAMOND GRANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 FLEMING DR APT B
AKRON OH
44311-1343
US

IV. Provider business mailing address

694 FLEMING DR APT B
AKRON OH
44311-1343
US

V. Phone/Fax

Practice location:
  • Phone: 234-419-4764
  • Fax:
Mailing address:
  • Phone: 234-419-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: