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NPI Code Detail

MEDICARE: DIAMOND HILL OPERATOR, LLC

MEDICARE: DIAMOND HILL OPERATOR, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1790136703
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIAMOND HILL OPERATOR, LLC
Provider Business Mailing Address
First Line : 585 PROSPECT ST
Second Line : UNIT 304
City : LAKEWOOD
State : NJ
Zip : 08701-5073
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 NEW TURNPIKE RD
Second Line :
City : TROY
State : NY
Zip : 12182-1412
Country : US
Telephone Number : 518-235-1410
Fax Number :
Authorized Official
Title or Position : AUTHORIZED PERSON
Name : MICHAEL NETZER
Credential :
Telephone Number : 732-905-6440
Provider Enumeration Date : 06/30/2016
Last Update Date : 06/30/2016

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