Provider Demographics
NPI:1104497627
Name:DIGNITY HOSPICE LLC
Entity type:Organization
Organization Name:DIGNITY HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-288-0555
Mailing Address - Street 1:401 N BRAND BLVD STE L103F
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4427
Mailing Address - Country:US
Mailing Address - Phone:951-288-0555
Mailing Address - Fax:
Practice Address - Street 1:401 N BRAND BLVD STE L103F
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4427
Practice Address - Country:US
Practice Address - Phone:951-288-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based