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Organization

DIAMOND LIFE SERVICES CHARITY INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEREMY LUNDQUIST (OWNER)
(757) 752-2712
Entity
Organization

Contact information

Practice address
935 VIRGILINA AVENUE, NORFOLK, VA 23503
(757) 752-2710
(757) 890-3044
Mailing address
PO BOX 896, NEWPORT NEWS, VA 23607-0896
(757) 594-6251
(757) 890-3044

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
VA

Other

Enumeration date
05/04/2015
Last updated
05/04/2015
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