Diamond Developmental Center Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

3DIMIND006 Issued in ID

Legal business name

DIAMOND DEVELOPMENTAL CENTER INC

Practice address

915 Parkcentre Way Ste 2
Suite 102
Nampa, ID 83651-1748

Phone

(208) 465-5114

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dan Fazzini, PHD

Title

President

Phone

(208) 465-5114

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1144366576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 12TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514656",
            "telephone_number": "208-465-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 PARKCENTRE WAY STE 2",
            "address_2": "SUITE 102",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511748",
            "telephone_number": "208-465-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND DEVELOPMENTAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "FAZZINI",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-465-5114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "ID",
            "license": "3DIMIND006",
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "ID",
            "license": "4DIMOND036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0026221800",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806166400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002621500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002621700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karyn Devereux, DPT
• Kiley Devor, PT, DPT
• Marissa Nicole Dey, MS SLP
• Allison Clark Deyette, PHARMD
• Diagnostic Pathology Services Inc
• Diamond Rose Counseling and Wellness, PLLC
• Judy Diaz, LMSW
• Taylor Diaz, LMSW
• Diana Dice, PA-C
• Christine Dickens, OT

• Developmentally Disabled Services Day Training Agency in Nampa, ID
• Providers in Nampa, ID by specialty
• Developmentally Disabled Services Day Training Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.