Provider Demographics
NPI: | 1013226976 |
---|---|
Name: | DIGNITY HOME HEALTH CARE, LLC |
Entity Type: | Organization |
Organization Name: | DIGNITY HOME HEALTH CARE, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT /CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | NATHAN |
Authorized Official - Middle Name: | ALLEN |
Authorized Official - Last Name: | MOORE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | BS, CCM, CBIS |
Authorized Official - Phone: | 231-632-8180 |
Mailing Address - Street 1: | 5377 BATES RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WILLIAMSBURG |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49690-9739 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 855-482-3442 |
Mailing Address - Fax: | 855-482-3442 |
Practice Address - Street 1: | 250 MONROE AVENUE NORTHWEST |
Practice Address - Street 2: | SUITE 400 |
Practice Address - City: | GRAND RAPIDS |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49503 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-482-3442 |
Practice Address - Fax: | 855-482-3442 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-09-27 |
Last Update Date: | 2013-11-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
251E00000X | ||
MI | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |