Healthcare Provider Details

I. General information

NPI: 1689707770
Provider Name (Legal Business Name): ELDER SERVICES OF WORCESTER AREA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 MILLBROOK ST STE 100
WORCESTER MA
01606-2842
US

IV. Provider business mailing address

411 CHANDLER ST
WORCESTER MA
01602-3329
US

V. Phone/Fax

Practice location:
  • Phone: 508-756-1545
  • Fax: 508-754-7771
Mailing address:
  • Phone: 508-756-1545
  • Fax: 508-754-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. LOUIS M SWAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 508-756-1545