=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992511745
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIGNITY KARE CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2024
-----------------------------------------------------
Last Update Date | 12/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 H ST STE 5000
-----------------------------------------------------
City | CHULA VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91910-5561
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-635-5568
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 H ST STE 5000
-----------------------------------------------------
City | CHULA VISTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91910-5561
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-635-5568
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER- PRESIDENT
-----------------------------------------------------
Name | DEEPA KURUP
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-635-5568
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------