Healthcare Provider Details

I. General information

NPI: 1962532416
Provider Name (Legal Business Name): SAINT FRANCIS HOME ADULT DAY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PLANTATION ST
WORCESTER MA
01604-3025
US

IV. Provider business mailing address

101 PLANTATION ST
WORCESTER MA
01604-3025
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-8605
  • Fax: 508-791-6954
Mailing address:
  • Phone: 508-755-8605
  • Fax: 508-791-6954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number845
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1948571
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerMEDICAID ADULT DAY HEALTH
# 2
Identifier0910899
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name: MR. THOMAS A DEVANEY
Title or Position: CONTROLLER
Credential:
Phone: 508-755-8605