Diamond Enterprize LLC
In Home Supportive Care in Rockford, IL. Organization (NPI-2).
NPI number1912588468
StatusActive
Last updated in NPPESApr 16, 2021
Details
- NPI
- 1912588468
- Entity type
- Organization (NPI-2)
- Legal business name
- Diamond Enterprize LLC
- Organization subpart
- No
- Enumeration date
- Apr 16, 2021
- Certification date
- Apr 16, 2021
- Last updated
- Apr 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 372600000X | Adult Companion | – | – | |
| 374U00000X | Home Health Aide | – | – | |
| 385H00000X | Respite Care | – | – |
Practice location
124 N Water St Ste 208Rockford, IL 61107-3959
Phone 815-977-3351
Mailing address
124 N Water St Ste 208Rockford, IL 61107-3959
Phone 815-977-3351
Authorized official
Louise Marie Crayton
President
8472437916
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