Healthcare Provider Details

I. General information

NPI: 1366353369
Provider Name (Legal Business Name): AT HOME WITH DIGNITY INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E MAIN ST STE 72
HAVELOCK NC
28532-2375
US

IV. Provider business mailing address

PO BOX 1088
HAVELOCK NC
28532-1088
US

V. Phone/Fax

Practice location:
  • Phone: 252-639-8737
  • Fax:
Mailing address:
  • Phone: 252-639-8737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TYTIANA PRIDGEN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 252-639-8737