# DIAMOND SUPPORTED LIVING SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437225513
- **Authorized official:** TAZENA E. KENNEDY (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (904) 307-6844

## Contact information

- **Practice address:** 330 IVY ST, JACKSONVILLE, FL 32206-6350
- **Practice address phone:** (904) 307-6844
- **Practice address fax:** (904) 924-1174
- **Mailing address:** PO BOX 2678, JACKSONVILLE, FL 32203-2678
- **Mailing address phone:** (904) 307-6844
- **Mailing address fax:** (904) 924-1174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 687831896 68783189 | FL | Yes |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 08/22/2020