Healthcare Provider Details

I. General information

NPI: 1013315472
Provider Name (Legal Business Name): DIAMOND ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DEVONSHIRE RD
LYNCHBURG VA
24501-2301
US

IV. Provider business mailing address

225 DEVONSHIRE RD P O BOX 12132 LYNCHBURG VA 24506
LYNCHBURG VA
24501-2301
US

V. Phone/Fax

Practice location:
  • Phone: 434-385-6779
  • Fax:
Mailing address:
  • Phone: 434-385-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. CLARA P JONES
Title or Position: OWNER/PARTNER
Credential:
Phone: 434-385-6779