# DIGNITY LIVING CENTERS OF NORTH AMERICA PALO VERDE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639565922
- **Authorized official:** MS. JULIE ANNA HENDERSHOTT R.N. (PARTNER/ADMINISTRATOR/MANAGER)
- **Authorized official phone:** (480) 658-6920

## Contact information

- **Practice address:** 4614 W PALO VERDE DR, GLENDALE, AZ 85301-6249
- **Practice address phone:** (623) 934-0094
- **Practice address fax:** (480) 247-5288
- **Mailing address:** 4614 W PALO VERDE DR, GLENDALE, AZ 85301-6249
- **Mailing address phone:** (623) 934-0094
- **Mailing address fax:** (480) 247-5288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 04/13/2015
- **Last updated:** 04/13/2015