Organization
DIGNITY HEALTH
Active
Parent organization
DIGNITY HEALTH
Other names
Mercy Medical Center Mt Shasta DP SNF
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY HEALTH
Authorized official
JOE D'ANGINA (CHIEF FINANCIAL OFFICER)
(530) 225-6121
Entity
Organization
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-6111
(530) 926-9373
Mailing address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-6111
(530) 926-9373
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
230000015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721561129
IRS
CA
01
—
721561129960670000
WPS-TRICARE
CA
05
—
LTC55282H
—
CA
Enumeration date
08/16/2005
Last updated
01/08/2021
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