Organization
ODD FELLOWS HOME OF MASSACHUSETTS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARENCE PLANT (SECRETARY BOARD OF TRUSTEES)
(508) 853-6687
Entity
Organization
Contact information
Practice address
104 RANDOLPH RD, WORCESTER, MA 01606-2465
(508) 853-6687
(508) 853-8103
Mailing address
104 RANDOLPH ROAD, WORCESTER, MA 01606
(508) 853-6687
(508) 853-8103
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0918
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0998818
—
MA
Enumeration date
01/23/2007
Last updated
12/16/2015
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