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Organization
DIGNITY HEALTH
Active
Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
Marian Extended Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
SUE ANDERSEN (CHIEF FINANCIAL OFFICER)
(805) 739-3110
Entity
Organization
Contact information
Practice address
1530 CYPRESS WAY, SANTA MARIA, CA 93454-5900
(805) 739-3650
(805) 922-9067
Mailing address
1530 CYPRESS WAY, SANTA MARIA, CA 93454-5900
(805) 739-3650
(805) 922-9067
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050000040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245100
AETNA
CA
01
—
651190935
IRS
CA
01
—
651190935934540006
WPS TRICARE
CA
05
—
LTC55236H
—
CA
01
—
ZZZA4203Z
BLUE SHIELD OF CA
—
Enumeration date
03/01/2007
Last updated
02/23/2017
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