Healthcare Provider Details

I. General information

NPI: 1518186030
Provider Name (Legal Business Name): DIGNITY CARE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 FAITH DR
SALINA KS
67401-5269
US

IV. Provider business mailing address

745 FAITH DR
SALINA KS
67401-5269
US

V. Phone/Fax

Practice location:
  • Phone: 785-823-3434
  • Fax:
Mailing address:
  • Phone: 785-823-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberN085008
License Number StateKS

VIII. Authorized Official

Name: JOAN JERKOVICH
Title or Position: ADMINSTRATOR
Credential: ACHA
Phone: 785-823-3434