Provider Demographics
NPI:1184040883
Name:DIGNIFIED LOVE LP
Entity Type:Organization
Organization Name:DIGNIFIED LOVE LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:CHRYSTAL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:ST CNA
Authorized Official - Phone:801-638-7016
Mailing Address - Street 1:5636 S 4500 W
Mailing Address - Street 2:
Mailing Address - City:KEARNS
Mailing Address - State:UT
Mailing Address - Zip Code:84118-5117
Mailing Address - Country:US
Mailing Address - Phone:801-638-7016
Mailing Address - Fax:
Practice Address - Street 1:3659 S 4400 W
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-3150
Practice Address - Country:US
Practice Address - Phone:801-638-7016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8949840-0180251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health