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General NPI Number Information
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NPI Number | 1356851596
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Entity Type | Organization
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Legal Business Name | DIAMONDS ENTERPRISE HEALTH SERVICES,LLC
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 2221 PENINSULA DR # 209
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City | ERIE
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State | PA
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Zip | 16506-2954
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Country | US
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Telephone | 814-217-6728
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Fax | 814-217-1550
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Provider Business Mailing Address
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Address Line | 2221 PENINSULA DR STE 209
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City | ERIE
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State | PA
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Zip | 16506-2954
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Country | US
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Telephone | 814-217-6728
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Fax | 814-217-1550
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Authorized Official
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Title or Position | PRESIDENT/ALT ADMINISTRATOR
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Name | MR. ARREY STEVONE MBU AYANG
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Credential |
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Telephone | 814-217-6728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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