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General NPI Number Information
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NPI Number | 1871354472
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Entity Type | Organization
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Legal Business Name | DIAMOND STATE ADVISORY, LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 148 W STATE ST STE 105
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3055
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Country | US
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Telephone | 610-871-7444
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Fax | 484-732-8028
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Provider Business Mailing Address
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Address Line | 148 W STATE ST STE 105
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3055
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Country | US
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Telephone | 610-871-7444
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Fax | 484-732-8028
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Authorized Official
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Title or Position | OWNER
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Name | NANA OTCHERE-ADDO
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Credential |
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Telephone | 302-898-0208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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