DODGE PARK LLC NPI 1104017961

NPI Information

DODGE PARK LLC is an adult care home custodial care facility in Worcester, MA. The provider is 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 environment. DODGE PARK LLC NPI is 1104017961. The provider is registered as an organization entity type.
The provider Is Doing Business As Dodge Park Rest Home.

The provider's business location address is:

101 RANDOLPH RD
WORCESTER, MA
ZIP 01606-463
Phone: (508) 853-8180
Fax: (508) 853-4545

The provider's authorized official is Ben Herlinger .
The authorized official title is Member/manager and has the following contact phone number (818) 571-8972.

The enumeration date for this NPI number is 8/7/2007 and was last updated on 8/7/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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