Provider Demographics
NPI:1982334157
Name:OCTAGON DIGNITY HOME HEALTH
Entity Type:Organization
Organization Name:OCTAGON DIGNITY HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-683-6585
Mailing Address - Street 1:11440 W BERNARDO CT STE 317
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1641
Mailing Address - Country:US
Mailing Address - Phone:619-683-6585
Mailing Address - Fax:888-830-1484
Practice Address - Street 1:11440 W BERNARDO CT STE 317
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1641
Practice Address - Country:US
Practice Address - Phone:619-683-6585
Practice Address - Fax:888-830-1484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-12
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health