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General NPI Number Information
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NPI Number | 1508076944
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Entity Type | Organization
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Legal Business Name | DIGNITY HEALTH CONNECTED LIVING
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 200 MERCY OAKS DRIVE
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City | REDDING
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State | CA
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Zip | 96003-9641
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Country | US
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Telephone | 530-223-6034
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Fax | 530-226-3089
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Provider Business Mailing Address
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Address Line | 200 MERCY OAKS DRIVE
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City | REDDING
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State | CA
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Zip | 96003-9641
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Country | US
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Telephone | 530-223-6034
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Fax | 530-226-3089
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOE AYER
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Credential | MPH
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Telephone | 530-226-3064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 070000559
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License Number State | CA
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