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NPI 1083052823

NPI 1083052823 : DIANA'S HOMECARE, INC : HUNTERSVILLE, NC

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General NPI Number Information
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    NPI Number           |    1083052823
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    Entity Type          |    Organization 
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    Legal Business Name  |    DIANA'S HOMECARE, INC 
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Dates
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    Enumeration Date     |    06/13/2013
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    Last Update Date     |    06/13/2013
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Provider Practice Location Address
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    Address Line         |    402 HILLCREST DR 
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    City                 |    HUNTERSVILLE
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    State                |    NC
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    Zip                  |    28078-7856
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    Country              |    US
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    Telephone            |    704-456-8389
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    Fax                  |    704-256-9957
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Provider Business Mailing Address
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    Address Line         |    402 HILLCREST DR 
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    City                 |    HUNTERSVILLE
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    State                |    NC
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    Zip                  |    28078-7856
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    Country              |    US
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    Telephone            |    704-456-8389
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    Fax                  |    704-256-9957
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR/CEO
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    Name                 |     DIANA  DUNCAN 
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    Credential           |    
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    Telephone            |    704-456-8389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    MHL-060-1256
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    License Number State |    NC
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