Provider Demographics
NPI:1093733776
Name:PATER DIGNITAS INC
Entity Type:Organization
Organization Name:PATER DIGNITAS INC
Other - Org Name:CARMEL HILLS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BOWERSOX
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:831-624-1875
Mailing Address - Street 1:23795 WR HOLMAN HWY
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5903
Mailing Address - Country:US
Mailing Address - Phone:831-624-1875
Mailing Address - Fax:831-624-7138
Practice Address - Street 1:23795 WR HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5903
Practice Address - Country:US
Practice Address - Phone:831-624-1875
Practice Address - Fax:831-624-7138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000015314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR06055GMedicaid
CA056055Medicare Oscar/Certification