Back to Dignity

Key facts

NPI

1770169989

Entity type

Organization (NPI type 2)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Legal business name

BACK TO DIGNITY

Practice address

12615 N Cave Creek Rd
Phoenix, AZ 85022-5832

Phone

(702) 235-5650

NPI assigned

Mar 19, 2021

Organization subpart

No

Authorized official

Name

Taras L Collum

Title

Owner

Phone

(702) 235-5650

National Provider Directory

Locations

Interoperability endpoints

• Direct secure messaging: taras@backtodignity.com

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 19, 2021.

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1770169989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12615 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225832",
            "telephone_number": "702-235-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225832",
            "telephone_number": "702-235-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO DIGNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "COLLUM",
        "authorized_official_first_name": "TARAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-235-5650"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Taras@backtodignity.com",
            "affiliation": "N",
            "endpointDescription": "Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Direct messaging",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12615 N Cave Creek Rd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850225832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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