Diamond Enterprize LLC
In Home Supportive Care in Rockford, IL. Organization (NPI-2).
NPI number1487228904
StatusActive
Last updated in NPPESMay 19, 2021
Details
- NPI
- 1487228904
- Entity type
- Organization (NPI-2)
- Legal business name
- Diamond Enterprize LLC
- Organization subpart
- No
- Enumeration date
- May 19, 2021
- Certification date
- May 17, 2021
- Last updated
- May 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Practice location
124 N. Water StSuite 208
Rockford, IL 61107
Phone 815-977-3351
Mailing address
124 N. Water StSuite 208
Rockford, IL 61107
Phone 847-243-7916
Authorized official
Louise Marie Crayton
President
8472437916
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