Provider Demographics
NPI:1326363540
Name:DIGNITY HOSPICE
Entity Type:Organization
Organization Name:DIGNITY HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-288-0555
Mailing Address - Street 1:225 E BROADWAY
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1008
Mailing Address - Country:US
Mailing Address - Phone:818-285-9980
Mailing Address - Fax:
Practice Address - Street 1:301 FOREST AVE
Practice Address - Street 2:A-3
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2115
Practice Address - Country:US
Practice Address - Phone:323-539-3923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based