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General NPI Number Information
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NPI Number | 1699083683
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Entity Type | Organization
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Legal Business Name | DIANA ADULT HOME CARE
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 7464 NW 16TH ST
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City | PLANTATION
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State | FL
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Zip | 33313-5112
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Country | US
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Telephone | 954-316-9313
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Fax |
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Provider Business Mailing Address
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Address Line | 7464 NW 16TH ST
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City | PLANTATION
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State | FL
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Zip | 33313-5112
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Country | US
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Telephone | 954-316-9313
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MS. DIANIA THOMPSON
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Credential |
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Telephone | 954-316-9313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 6905810
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License Number State | FL
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