Diamond Lake Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DIAMOND LAKE HOME HEALTH CARE LLC

Practice address

2942 N 24TH St Suite 114
Apt 12
Phoenix, AZ 85016-7849

Phone

(602) 877-9355

NPI assigned

Nov 30, 2023

Organization subpart

No

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

Authorized official

Name

Adan S SamantarNPI 1033913728

Title

Owner/Ceo

Phone

(480) 278-1079

Specialties & licenses 1

Addresses

Other names 1

• Diamond lake home health care LLC Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adan S Samantar

  • Home Health Agency
  • Phoenix, AZ
  • NPI 1033913728
  NPD Authorized official

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1265208276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 N 24TH ST STE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167849",
            "telephone_number": "602-877-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2942 N 24TH ST SUITE 114",
            "address_2": "APT 12",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167849",
            "telephone_number": "602-877-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND LAKE HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "SAMANTAR",
        "authorized_official_first_name": "ADAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "480-278-1079"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamond lake home health care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Home Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.