Organization
AUTUMN VILLAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN D'URSO (OWNER)
(508) 852-3330
Entity
Organization
Contact information
Practice address
25 ORIOL DR, WORCESTER, MA 01605-1911
(508) 852-3330
(508) 595-1008
Mailing address
25 ORIOL DR, WORCESTER, MA 01605-1911
(508) 852-3330
(508) 595-1008
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0713
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0928402
—
MA
Enumeration date
07/18/2005
Last updated
08/22/2020
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