MEDICARE: DIGNIFIED HOME LIFE CARE

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	310400000X	Assisted Living Facility	000113	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952528531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGNIFIED HOME LIFE CARE

Provider Business Mailing Address
First Line	:	3330 CREEKSIDE DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-4027
Country	:	US
Telephone Number	:	907-333-2968
Fax Number	:	907-333-2968

Provider Business Practice Location Address
First Line	:	3330 CREEKSIDE DR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-4027
Country	:	US
Telephone Number	:	907-333-2968
Fax Number	:	907-333-2968

Authorized Official
Title or Position	:	OWNER ADMINISTRATOR
Name	:	MRS. CANDICE DIANE BELZ
Credential	:	LPN
Telephone Number	:	907-333-2968

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	08/22/2020

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Directions to “DIGNIFIED HOME LIFE CARE ” Practice Location

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