Provider Demographics
NPI:1518400886
Name:RIMA AGARONYAN
Entity Type:Organization
Organization Name:RIMA AGARONYAN
Other - Org Name:DIGNITY CARE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:RIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-385-7115
Mailing Address - Street 1:3274 E ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0605
Mailing Address - Country:US
Mailing Address - Phone:559-385-7115
Mailing Address - Fax:
Practice Address - Street 1:3274 E ACACIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0605
Practice Address - Country:US
Practice Address - Phone:559-385-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107206792310400000X, 3104A0625X, 3104A0630X, 311500000X, 311ZA0620X, 315D00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicaid