Provider Demographics
NPI:1346385192
Name:DIGNITY PLACE, INC
Entity Type:Organization
Organization Name:DIGNITY PLACE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXE. DIR.
Authorized Official - Prefix:
Authorized Official - First Name:LA MONIQUE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:BENFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-513-0399
Mailing Address - Street 1:252 KINGSFORD XING
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2669
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:252 KINGSFORD XING
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2669
Practice Address - Country:US
Practice Address - Phone:404-513-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 253Z00000X
GA110-R-0289261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care