# DIVERSITY HEALTH CRAE, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DINAMIC HEALTH CARE, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093113946
- **Legal business name:** DINAMIC HEALTH CARE, LLC
- **Authorized official:** VERNICE NELSON RN (ADMINISTRATOR/PRESIDENT)
- **Authorized official phone:** (708) 983-4623

## Contact information

- **Practice address:** 9141 S KEDZIE AVE, EVERGREEN PARK, IL 60805-1606
- **Practice address phone:** (708) 983-4623
- **Mailing address:** 9141 S KEDZIE AVE, EVERGREEN PARK, IL 60805-1606
- **Mailing address phone:** (708) 983-4623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/09/2014
- **Last updated:** 12/09/2014