Provider Demographics
NPI:1669080313
Name:DIAMOND AND PEARLS AFFILIATES L.L.C.
Entity type:Organization
Organization Name:DIAMOND AND PEARLS AFFILIATES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-887-8706
Mailing Address - Street 1:1243 PINE ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-3334
Mailing Address - Country:US
Mailing Address - Phone:678-887-8706
Mailing Address - Fax:
Practice Address - Street 1:1243 PINE ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-3334
Practice Address - Country:US
Practice Address - Phone:678-887-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No177F00000XOther Service ProvidersLodging
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No305S00000XManaged Care OrganizationsPoint of Service