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General NPI Number Information
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NPI Number | 1902330632
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Entity Type | Organization
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Legal Business Name | DIAMONDS OF MY HEART
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11884 E 10 MILE RD
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City | WARREN
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State | MI
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Zip | 48089-3901
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Country | US
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Telephone | 586-745-1752
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Fax |
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Provider Business Mailing Address
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Address Line | 20410 TERRELL ST
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City | DETROIT
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State | MI
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Zip | 48234-3209
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Country | US
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Telephone | 586-745-1752
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER CURTIS
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Credential |
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Telephone | 586-745-1752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MI
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