Organization
DODGE PARK AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHA SHALEV (MANAGER/MEMBER)
(508) 853-8180
Entity
Organization
Contact information
Practice address
101 RANDOLPH RD, WORCESTER, MA 01606-2463
(508) 853-8180
(508) 853-4545
Mailing address
101 RANDOLPH RD, WORCESTER, MA 01606-2463
(508) 853-8180
(508) 853-4545
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
8110
MA
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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