Provider Demographics
NPI:1851494231
Name:DIGNITY COMMUNITY CARE
Entity Type:Organization
Organization Name:DIGNITY COMMUNITY CARE
Other - Org Name:WOODLAND HEALTHCARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-669-5372
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-851-2258
Mailing Address - Fax:916-851-2536
Practice Address - Street 1:1207 FAIRCHILD CT
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4321
Practice Address - Country:US
Practice Address - Phone:530-406-2900
Practice Address - Fax:530-406-2909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY COMMUNITY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-07
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100000184251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ22281ZOtherBLUE SHIELD OF CA
651191375OtherIRS - SP TAX ID
CAHHA70075HMedicaid
651191375956950000OtherWPS TRICARE
CA057274Medicare Oscar/Certification