Organization Active NPI

Donna Kay Rest Home, Inc

  • Adult Care Home Facility
  • Worcester, MA
National Provider Identifier
1376538058
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
DONNA KAY REST HOME, INC
Practice address
16 Marble St
Worcester, MA 01603-2405
Phone
(508) 755-6667
Fax
(508) 831-7952
NPI assigned
Sep 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jena Kuzdzal
Title
Bookkeeper
Phone
(508) 949-7455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

16 Marble St
Worcester, MA 01603-2405

Mailing address

16 Marble St
Worcester, MA 01603-2405
Phone (508) 755-6667

Other identifiers 1

IdentifierTypeStateIssuer
5501776MedicaidMA

National Provider Directory

National Provider Directory

Locations

16 Marble St
Worcester, MA 01603
Phone (508) 752-9448

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376538058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MARBLE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032405",
            "telephone_number": "508-755-6667",
            "fax_number": "508-831-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MARBLE ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032405",
            "telephone_number": "508-755-6667",
            "fax_number": "508-831-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA KAY REST HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUZDZAL",
        "authorized_official_first_name": "JENA",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "508-949-7455"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501776",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.