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DODGE PARK REST HOME
NPI 1104017961
Custodial Care Facility - Adult Care Home in Worcester, MA

Active since August 07, 2007CLIA 22D2112381 · Waiver
101 RANDOLPH RD, WORCESTER, MA 01606(508) 853-8180(508) 853-4545 Get Directions Write a Review

NPPES record last updated: August 7, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dodge Park Rest Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DODGE PARK REST HOME (NPI 1104017961) is a healthcare organization registered as an adult care home in Worcester, Massachusetts and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through April 27, 2028 and lists Ben Herlinger, Member/manager, as its authorized official.

NPPES Registry Identity

NPI1104017961
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameDODGE PARK LLC
Location Address101 RANDOLPH RDWorcester, MA 01606-2463
Mailing Address101 Randolph RdWorcester, MA 01606-2463 · (508) 853-8180 · Fax (508) 853-4545
Phone(508) 853-8180
Fax(508) 853-4545
Organization SubpartNo
Authorized OfficialBen HerlingerMember/manager · (818) 571-8972
Enumeration DateAugust 7, 2007
✔ NPI 1104017961 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License✔ Licensed in MA · 1318
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
101 RANDOLPH RD, Worcester, MA 01606
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Other Names 1

Doing Business AsDodge Park Rest Home

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2112381

Dodge Park Rest Home · Worcester, MA
Active · expires Apr 27, 2028
CLIA Number22D2112381
Laboratory TypeRest Home
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorMicha Shalev
Laboratory Phone(508) 853-8180
Laboratory LocationDodge Park Rest Home101 Randolph Rd, Worcester, MA 01606
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DODGE PARK REST HOME INC.
Clinic/Center (Corporate Health)
101 RANDOLPH RD
WORCESTER, MA 01606
Worcester County (508) 853-8180
COURTENEY ELIZABETH ADA LINDBERG
Nurse Practitioner (Family)
101 RANDOLPH RD
WORCESTER, MA 01606
Worcester County (508) 853-8180
DODGE PARK AT HOME
In Home Supportive Care
101 RANDOLPH RD
WORCESTER, MA 01606
Worcester County (508) 853-8180

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dodge Park LLC's NPI number?

The NPI number for Dodge Park LLC is 1104017961. It was assigned to this organization in the NPPES registry on August 7, 2007. The provider is doing business as Dodge Park Rest Home.

Where is Dodge Park LLC located?

Dodge Park LLC is located at 101 Randolph Rd, Worcester, MA 01606. The listed phone number is (508) 853-8180.

What is Dodge Park LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Dodge Park LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2112381) is associated with this NPI, valid through April 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dodge Park LLC was last updated on August 7, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.