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NPI Code Detail

MEDICARE: DONNA KAY REST HOME, INC

MEDICARE: DONNA KAY REST HOME, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1311ZA0620XAdult Care Home Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376538058
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONNA KAY REST HOME, INC
Provider Business Mailing Address
First Line : 16 MARBLE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01603-2405
Country : US
Telephone Number : 508-755-6667
Fax Number : 508-831-7952
Provider Business Practice Location Address
First Line : 16 MARBLE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01603-2405
Country : US
Telephone Number : 508-755-6667
Fax Number : 508-831-7952
Authorized Official
Title or Position : BOOKKEEPER
Name : JENA KUZDZAL
Credential :
Telephone Number : 508-949-7455
Provider Enumeration Date : 09/19/2005
Last Update Date : 08/22/2020

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Directions to “DONNA KAY REST HOME, INC ” Practice Location

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