Dodge Park Llc in Worcester - Adult Care Home
Dodge Park Llc - NPI 1104017961
Dodge Park Llc is a Adult Care Home in Worcester, Massachusetts. Dodge Park Llc practices all healthcare services and medical treatments related to Adult Care Home. The NPI Number for Dodge Park Llc is 1104017961. The last update date is 2007-08-07.
Dodge Park Llc's current location address is 101 Randolph Rd, Worcester, Massachusetts. You can contact this provider via phone number 5088538180 and fax number 5088534545. The mailing address for Dodge Park Llc is 101 Randolph Rd, Worcester, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dodge Park Llc |
|---|---|
| Address | 101 Randolph Rd, Worcester, Massachusetts |
| Phone Number | 5088538180 |
| Fax Number | 5088534545 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEMBER/MAN |
|---|---|
| Authorized Official Name | Herlinger Ben |
| Telephone Number | 8185718972 |
NPI Number Detail
| NPI Number | 1104017961 |
|---|---|
| Provider Enumeration Date | 2007-08-07 |
| Last Updated Date | 2007-08-07 |
Provider Mailing Address Detail
| Address | 101 Randolph Rd |
|---|---|
| City | Worcester |
| State | Massachusetts (MA) |
| Post Code | 16062463 |
| Phone Number | 5088538180 |
| Fax Number | 5088534545 |
Provider's Primary Taxonomy Detail
| Speciality | Adult Care Home |
|---|---|
| Taxonomy | 311Za0620X |
| Licence No | 1318 |
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Definition: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like en |
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What is the unique 10-digit identifier code assigned to Dodge Park Llc by the Centers for Medicare & Medicaid Services?
The Dodge Park Llc has been issued the NPI (National Provider Identifier) 1104017961 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Dodge Park Llc located?
The Dodge Park Llc is located at 101 Randolph Rd, Worcester, MA 16062463.
What is Dodge Park Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Dodge Park Llc is Adult Care Home, and the corresponding taxonomy classification code for this specialized field is 311Za0620X.
On what date did the Centers for Medicare & Medicaid Services issue the 1104017961 to Dodge Park Llc?
The Dodge Park Llc received its 1104017961 assignment from the Centers for Medicare & Medicaid Services on 2007-08-07.
When was the Dodge Park Llc's information last updated?
The Dodge Park Llc's information was last updated on 2007-08-07.