Provider Demographics
NPI:1679603831
Name:DIVERSIFIED HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:DIVERSIFIED HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:217-356-1111
Mailing Address - Street 1:510 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3971
Mailing Address - Country:US
Mailing Address - Phone:217-356-1111
Mailing Address - Fax:217-356-1059
Practice Address - Street 1:510 W PARK AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3971
Practice Address - Country:US
Practice Address - Phone:217-356-1111
Practice Address - Fax:217-356-1059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1000116251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health