Provider Demographics
NPI:1871354472
Name:DIAMOND STATE ADVISORY, LLC
Entity type:Organization
Organization Name:DIAMOND STATE ADVISORY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OTCHERE-ADDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-898-0208
Mailing Address - Street 1:312 WEST STATE STREET SUITE 213
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348
Mailing Address - Country:US
Mailing Address - Phone:610-871-7444
Mailing Address - Fax:
Practice Address - Street 1:312 WEST STATE STREET SUITE 213
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348
Practice Address - Country:US
Practice Address - Phone:610-871-7444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care