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General NPI Number Information
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NPI Number | 1245633858
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Entity Type | Organization
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Legal Business Name | HUMAN DIGNITY FOUNDATION
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Dates
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Enumeration Date | 09/28/2014
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Last Update Date | 09/28/2014
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Provider Practice Location Address
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Address Line | 1493 N SHEPHERD RD
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City | WASHOUGAL
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State | WA
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Zip | 98671-8327
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Country | US
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Telephone | 360-210-4371
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Fax | 360-835-3319
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Provider Business Mailing Address
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Address Line | 1470 N 20TH ST
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City | WASHOUGAL
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State | WA
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Zip | 98671-8278
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Country | US
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Telephone | 360-606-5262
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Fax | 360-835-3319
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Authorized Official
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Title or Position | TREASURER
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Name | MR. THOMAS MCCAULLEY
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Credential |
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Telephone | 360-606-5262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 752701
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License Number State | WA
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