Provider Demographics
NPI:1821238148
Name:BENTLEY SAINT FRANCIS, LLC
Entity Type:Organization
Organization Name:BENTLEY SAINT FRANCIS, LLC
Other - Org Name:SAINT FRANCIS ADULT DAY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-372-4004
Mailing Address - Street 1:37 THORNE STREET
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604
Mailing Address - Country:US
Mailing Address - Phone:508-755-8605
Mailing Address - Fax:508-791-6954
Practice Address - Street 1:37 THORNE STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604
Practice Address - Country:US
Practice Address - Phone:508-752-2546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110081997BMedicaid
MA1907107Medicaid