Healthcare Provider Details

I. General information

NPI: 1194675462
Provider Name (Legal Business Name): WORCESTER REHAB SNF OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 PROVIDENCE ST
WORCESTER MA
01604-4429
US

IV. Provider business mailing address

10913 S RIVER FRONT PKWY STE 290
SOUTH JORDAN UT
84095-3507
US

V. Phone/Fax

Practice location:
  • Phone: 508-860-5000
  • Fax:
Mailing address:
  • Phone: 508-860-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN RAMOS
Title or Position: MANAGER
Credential:
Phone: 508-860-5000