Provider Demographics
NPI:1902541386
Name:DIGNITY SENIOR LIVING
Entity Type:Organization
Organization Name:DIGNITY SENIOR LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAWALI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-312-6550
Mailing Address - Street 1:140 E HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4268
Mailing Address - Country:US
Mailing Address - Phone:602-312-6550
Mailing Address - Fax:
Practice Address - Street 1:515 S HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-3511
Practice Address - Country:US
Practice Address - Phone:602-312-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-01
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility