Provider Demographics
NPI:1942996632
Name:DIGNITY AND WISDOM
Entity Type:Organization
Organization Name:DIGNITY AND WISDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SABA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TESFAY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:612-423-5046
Mailing Address - Street 1:2255 EL RANCHO VIS
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-1725
Mailing Address - Country:US
Mailing Address - Phone:714-261-7435
Mailing Address - Fax:714-451-4488
Practice Address - Street 1:2330 CAMINO ESCONDIDO
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-1542
Practice Address - Country:US
Practice Address - Phone:714-261-7435
Practice Address - Fax:714-451-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility