Provider Demographics
NPI:1013226976
Name:DIGNITY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:DIGNITY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CCM, CBIS
Authorized Official - Phone:231-632-8180
Mailing Address - Street 1:5377 BATES RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-9739
Mailing Address - Country:US
Mailing Address - Phone:855-482-3442
Mailing Address - Fax:855-482-3442
Practice Address - Street 1:250 MONROE AVENUE NORTHWEST
Practice Address - Street 2:SUITE 400
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:855-482-3442
Practice Address - Fax:855-482-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health