Dodge Park LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1318 Issued in MA

Legal business name

DODGE PARK LLC

Practice address

101 Randolph Rd
Worcester, MA 01606-2463

Phone

(508) 853-8180

Fax

(508) 853-4545

NPI assigned

Aug 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ben Herlinger

Title

Member/Manager

Phone

(818) 571-8972

Specialties & licenses 1

Addresses

Other names 1

• Dodge Park Rest Home Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1104017961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RANDOLPH RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062463",
            "telephone_number": "508-853-8180",
            "fax_number": "508-853-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RANDOLPH RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062463",
            "telephone_number": "508-853-8180",
            "fax_number": "508-853-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "HERLINGER",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "818-571-8972",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MA",
            "license": "1318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dodge Park Rest Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Lea Dobell, MD
• Elizabeth Dobles, MD
• Michelina Libera Docimo, M.S.
• Dominique Matica Dockery, MD
• Dodge Park at Home
• Dodge Park Rest Home Inc.
• Linda L Dodge, N.P.
• Robyn Dodge
• Hannah Dodier
• Kasia S Dodman, NP

• Adult Care Home Facility in Worcester, MA
• Providers in Worcester, MA by specialty
• Adult Care Home Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.