Provider Demographics
NPI:1891723557
Name:DIGNITY HOSPICE, LLC
Entity Type:Organization
Organization Name:DIGNITY HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRICE
Authorized Official - Middle Name:NEFF
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:801-492-4892
Mailing Address - Street 1:357 EAST 50 SOUTH, SUITE B
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3837
Mailing Address - Country:US
Mailing Address - Phone:801-492-4892
Mailing Address - Fax:801-492-4892
Practice Address - Street 1:357 EAST 50 SOUTH, SUITE B
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3837
Practice Address - Country:US
Practice Address - Phone:801-492-4892
Practice Address - Fax:801-492-4892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT461562Medicare Oscar/Certification