Organization
DIGNITY COMMUNITY CARE
Active
Parent organization
DIGNITY COMMUNITY CARE
Other names
Glendale Memorial Hospital and Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIGNITY COMMUNITY CARE
Authorized official
KORA GUOYAVATIN (CHIEF FINANCIAL OFFICER)
(818) 502-2204
Entity
Organization
Contact information
Practice address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-2215
(818) 409-7688
Mailing address
1420 S CENTRAL AVE, GLENDALE, CA 91204-2508
(818) 502-1900
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
930000099
CA
273Y00000X
Rehabilitation Hospital Unit
930000099
CA
282N00000X
General Acute Care Hospital
Primary
930000099
CA
314000000X
Skilled Nursing Facility
930000099
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050058B000000
CMS SECTION 1011
CA
01
—
774509
AETNA
CA
01
—
951642380
IRS
CA
01
—
951642380912040003
WPS TRICARE
CA
01
—
CGP164950
DHS
CA
01
—
GMH
UNIVERSAL
CA
05
—
HSC30058G
—
CA
05
—
HSM30058G
—
CA
05
—
ZZT30058G
—
CA
05
—
ZZT40058G
—
CA
01
—
ZZZA1903Z
BLUE SHIELD
CA
Enumeration date
01/03/2007
Last updated
12/08/2020
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