Organization
WILLOWS AT WORCESTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY SACON (CHIEF FINANCIAL OFFICER)
(508) 898-3490
Entity
Organization
Contact information
Practice address
101 BARRY RD, WORCESTER, MA 01609-1154
(508) 798-3727
Mailing address
101 BARRY RD, WORCESTER, MA 01609-1154
(508) 798-3727
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5503329
—
MA
Enumeration date
04/09/2008
Last updated
01/20/2012
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