Healthcare Provider Details
I. General information
NPI: 1457906141
Provider Name (Legal Business Name): WITH DIGNITY TOO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
815 N WESTERN AVE
MARION IN
46952-2507
US
IV. Provider business mailing address
1080 N 400 E
KOKOMO IN
46901-3623
US
V. Phone/Fax
- Phone: 765-450-6554
- Fax: 765-450-6744
- Phone: 765-450-6554
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERIC
S
BROWN
Title or Position: OFFICE MANAGER
Credential:
Phone: 765-450-6554