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General NPI Number Information
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NPI Number | 1942799200
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Entity Type | Organization
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Legal Business Name | BRIGHT DIAMOND HOME HEALTH, INC.
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 05/02/2018
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Provider Practice Location Address
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Address Line | 5261 DELMAR BLVD STE 216
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1013
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Country | US
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Telephone | 800-510-2744
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Fax |
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Provider Business Mailing Address
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Address Line | 7111 WOODROW AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63121-5121
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Country | US
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Telephone | 314-546-6526
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEAIGNER THOMAS
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Credential |
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Telephone | 314-546-6526
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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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