Dodge Park LLC
NPI #1104017961 in Worcester, Massachusetts
Provider Information
- NPI Number
- 1104017961
- Entity Type
- Organization
- Organization Name
- Dodge Park LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Aug 7, 2007
- Last Updated
- Aug 7, 2007
Practice Location
- Address
- 101 RANDOLPH RD
- City
- Worcester
- State
- Massachusetts
- ZIP Code
- 01606-2463
- Phone
- (508) 853-8180
Authorized Official
- Name
- MR. BEN HERLINGER
- Title
- MEMBER/MANAGER
- Phone
- (818) 571-8972
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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