MEDICARE: DIGNITY DISABILITY SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1558149419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNITY DISABILITY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 570007
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89157-0007
Country	:	US
Telephone Number	:	702-756-9247
Fax Number	:	702-935-4654

Provider Business Practice Location Address
First Line	:	3825 W CHEYENNE AVE STE 604
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3422
Country	:	US
Telephone Number	:	702-756-9247
Fax Number	:	702-935-4654

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. AMBROSIA LEE CRUMP
Credential	:	LCSW
Telephone Number	:	702-581-1825

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	03/06/2026

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