Provider Demographics
NPI:1972705630
Name:DIGNITY FIRST INC.
Entity Type:Organization
Organization Name:DIGNITY FIRST INC.
Other - Org Name:HOME SWEET HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED ASSISTED LIVING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LALFM
Authorized Official - Phone:928-300-6993
Mailing Address - Street 1:PO BOX 1002
Mailing Address - Street 2:
Mailing Address - City:CAMP VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:86322-1002
Mailing Address - Country:US
Mailing Address - Phone:928-300-6993
Mailing Address - Fax:928-639-4398
Practice Address - Street 1:2594 S MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5901
Practice Address - Country:US
Practice Address - Phone:928-639-4364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH-5061310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ916281Medicaid