Provider Demographics
NPI:1942805312
Name:DIGNIFIED CARE LLC
Entity Type:Organization
Organization Name:DIGNIFIED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:ESESE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:616-856-9191
Mailing Address - Street 1:3640 BRAMBLEBRRY DR NW
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321
Mailing Address - Country:US
Mailing Address - Phone:616-856-9191
Mailing Address - Fax:616-228-4477
Practice Address - Street 1:2720 44TH ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512
Practice Address - Country:US
Practice Address - Phone:616-551-1544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home