Provider Demographics
NPI:1326543000
Name:DIGNIFIED CARE MANAGEMENT, INC
Entity Type:Organization
Organization Name:DIGNIFIED CARE MANAGEMENT, INC
Other - Org Name:DIGNIFIED CARE MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-227-5222
Mailing Address - Street 1:2915 EL CAMINO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5224
Mailing Address - Country:US
Mailing Address - Phone:702-227-5222
Mailing Address - Fax:
Practice Address - Street 1:2915 EL CAMINO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5224
Practice Address - Country:US
Practice Address - Phone:702-227-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3228-AGC-22311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home