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General NPI Number Information
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NPI Number | 1275155780
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Entity Type | Organization
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Legal Business Name | DIAMOND CARE COMPANION AGENCY INC.
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 7 LATTICE CT
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City | RIDGE
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State | NY
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Zip | 11961-1901
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Country | US
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Telephone | 631-345-5674
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Fax |
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Provider Business Mailing Address
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Address Line | 7 LATTICE CT
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City | RIDGE
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State | NY
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Zip | 11961-1901
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Country | US
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Telephone | 631-345-5674
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Fax |
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Authorized Official
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Title or Position | CEO /OWNER
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Name | MR. RICHARD A BUROKER
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Credential |
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Telephone | 631-560-6889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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