Provider Demographics
NPI:1902439425
Name:DIGNITY HEALTH CONNECTED LIVING
Entity Type:Organization
Organization Name:DIGNITY HEALTH CONNECTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA TECHNOLOGY ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-226-3081
Mailing Address - Street 1:200 MERCY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8641
Mailing Address - Country:US
Mailing Address - Phone:530-226-3081
Mailing Address - Fax:
Practice Address - Street 1:200 MERCY OAKS DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-8641
Practice Address - Country:US
Practice Address - Phone:530-226-3081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013348358Medicaid
CA1508076944Medicaid