Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Psychiatric Residential Treatment Facility |
323P00000X | |||
Substance Abuse Disorder Rehabilitation Facility |
324500000X |
| NPI Number | 1285116947 |
| LBN Legal business name | THE DIAMOND TREE LLC |
| Authorized official | TRAVIS WHITTAKER - (OWNER/CEO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/29/2018 |
| Last updated | 02/04/2025 - More than a year ago |
| Identifiers | n/a |
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