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General NPI Number Information
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NPI Number | 1194938092
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Entity Type | Organization
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Legal Business Name | DIGNITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17201 EAST US 40 HWY SUITE 205
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6438
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Country | US
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Telephone | 816-795-5534
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Fax | 816-795-5526
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Provider Business Mailing Address
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Address Line | 17201 EAST U.S. 40 HWY SUITE 205
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6438
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Country | US
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Telephone | 816-795-5534
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Fax | 816-795-5526
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MARILYN CHRISTINE BRUURSEMA
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Credential | RN
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Telephone | 816-795-5534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 722792-0-095-0000
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License Number State | MO
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