NPI 1104017961

Dodge Park LLC

Organisation Adult Care Home Facility Worcester, MA

Practice location

Address: 101 Randolph Rd, Worcester, MA 01606-2463
Phone: (508) 853-8180
Fax: (508) 853-4545

Authorised official

Name: Ben Herlinger
Title: Member/Manager
Phone: (818) 571-8972

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 1318 (MA)

Other Custodial Care Facility providers in Massachusetts →

Registry record

NPI: 1104017961
Entity type: Organization
NPI issued: 7 Aug 2007
Record last updated: 7 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.