Organization
DIAMOND DEVELOPMENTAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAN FAZZINI PHD (PRESIDENT)
(208) 465-5114
Entity
Organization
Contact information
Practice address
915 PARKCENTRE WAY STE 2, SUITE 102, NAMPA, ID 83651-1748
(208) 465-5114
Mailing address
811 12TH AVE S, NAMPA, ID 83651-4656
(208) 465-5114
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3DIMIND006
ID
251C00000X
Developmentally Disabled Services Day Training Agency
4DIMOND036
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002621500
—
ID
05
—
002621700
—
ID
05
—
0026221800
—
ID
05
—
806166400
—
ID
Enumeration date
01/30/2007
Last updated
05/05/2008
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