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General NPI Number Information
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NPI Number | 1659912376
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Entity Type | Organization
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Legal Business Name | DIAMOND PERSONAL CARE, LLC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 33 MACARTHUR DR
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City | CONWAY
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State | AR
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Zip | 72032-4510
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Country | US
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Telephone | 501-358-6180
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Fax | 501-504-6933
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Provider Business Mailing Address
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Address Line | 33 MACARTHUR DR
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City | CONWAY
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State | AR
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Zip | 72032-4510
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Country | US
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Telephone | 501-358-6180
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Fax | 501-504-6933
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Authorized Official
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Title or Position | OWNER
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Name | NANCY ISCH DESONIE
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Credential |
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Telephone | 501-358-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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