Healthcare Provider Details

I. General information

NPI: 1508076944
Provider Name (Legal Business Name): DIGNITY HEALTH CONNECTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY OAKS DRIVE
REDDING CA
96003-9641
US

IV. Provider business mailing address

200 MERCY OAKS DRIVE
REDDING CA
96003-9641
US

V. Phone/Fax

Practice location:
  • Phone: 530-223-6034
  • Fax: 530-226-3089
Mailing address:
  • Phone: 530-223-6034
  • Fax: 530-226-3089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number070000559
License Number StateCA

VIII. Authorized Official

Name: JOE AYER
Title or Position: EXECUTIVE DIRECTOR
Credential: MPH
Phone: 530-226-3064