Basic Information
| Provider Information | |||||||||
| NPI: | 1780134346 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DIGNITY SENIOR LIVING, LTD. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | OCEANSIDE HAWAII ASSISTED LIVING | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53-594 KAMEHAMEHA HWY | ||||||||
| Address2: | |||||||||
| City: | HAUULA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967179648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082931100 | ||||||||
| FaxNumber: | 8084502246 | ||||||||
| Practice Location | |||||||||
| Address1: | 53-594 KAMEHAMEHA HWY | ||||||||
| Address2: | |||||||||
| City: | HAUULA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967179648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082931100 | ||||||||
| FaxNumber: | 8084502246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2016 | ||||||||
| LastUpdateDate: | 10/07/2016 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CHEN | ||||||||
| AuthorizedOfficialFirstName: | ALBERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8082931100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | OHCA#17-ALF | HI | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.