Healthcare Provider Details

I. General information

NPI: 1780134346
Provider Name (Legal Business Name): DIGNITY SENIOR LIVING, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53-594 KAMEHAMEHA HWY
HAUULA HI
96717-9648
US

IV. Provider business mailing address

53-594 KAMEHAMEHA HWY
HAUULA HI
96717-9648
US

V. Phone/Fax

Practice location:
  • Phone: 808-293-1100
  • Fax: 808-450-2246
Mailing address:
  • Phone: 808-293-1100
  • Fax: 808-450-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberOHCA#17-ALF
License Number StateHI

VIII. Authorized Official

Name: MR. ALBERT CHEN
Title or Position: OFFICER
Credential:
Phone: 808-293-1100