Dodge Park LLC
Custodial Care Facility, Adult Care Home in Worcester, Massachusetts
1104017961- Practice location
- 101 Randolph RD, Worcester, MA 01606-2463
- Phone
- 508-853-8180
- Fax
- 508-853-4545
- Last updated
- August 7, 2007
Dodge Park LLC is a healthcare organization based in Worcester, MA. Dodge Park LLC practices in Worcester, MA. The NPI Number for Dodge Park LLC is 1104017961 and holds a License No. 1318 (MA). The current practice location address for Dodge Park LLC is 101 Randolph RD, Worcester, MA 01606-2463 and can be reached out via phone at 508-853-8180 and via fax at 508-853-4545.
Provider Profile Details
- NPI Number
- 1104017961
- Provider Name
- Dodge Park LLC
- Provider Entity Type
- Organization
- Address
- 101 Randolph RD, Worcester, MA 01606-2463
- Phone Number
- 508-853-8180
- Fax Number
- 508-853-4545
- Primary Taxonomy
- Custodial Care Facility, Adult Care Home · 311ZA0620X
- Organization Subpart
- No
- Authorized Official
- Mr. Ben Herlinger · Member/Manager · 818-571-8972
- Other Names
- Dodge Park Rest Home (Doing Business As)
- Provider Enumeration Date
- August 7, 2007
- Last Update Date
- August 7, 2007
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 101 Randolph RD
Worcester, MA 01606-2463 - City
- Worcester
- State
- Massachusetts
- Zip
- 01606-2463
- Phone Number
- 508-853-8180
- Fax Number
- 508-853-4545
Provider Business Mailing Address Details
- Address
- 101 Randolph RD
Worcester, MA 01606-2463 - City
- Worcester
- State
- MA
- Zip
- 01606-2463
- Phone Number
- 508-853-8180
- Fax Number
- 508-853-4545
License Information
- License Number
- 1318
- License State
- MA
- Taxonomy
- Custodial Care Facility, Adult Care Home · 311ZA0620X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dodge Park LLC?
The NPI number of Dodge Park LLC is 1104017961. It was assigned on August 7, 2007 and is currently active in the NPPES registry.
What is the specialty of Dodge Park LLC?
Dodge Park LLC is registered under the primary taxonomy Custodial Care Facility, Adult Care Home (code 311ZA0620X), licensed in MA under license number 1318.
Where does Dodge Park LLC practice?
The practice location is 101 Randolph RD, Worcester, MA 01606-2463. The office can be reached at 508-853-8180 (phone) or 508-853-4545 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104017961 directly on the NPPES registry website.