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BURGOYNE REST HOME INC NPI 1104017292


NPI Information

NPI: 1104017292
Provider Name: BURGOYNE REST HOME INC
Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
53 HARTFORD ST
DORCHESTER, MA
ZIP 02125
Phone: (617) 445-1868
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BURGOYNE REST HOME INC is a nursing facility intermediate care facility in Dorchester, MA. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. BURGOYNE REST HOME INC NPI is 1104017292. The provider is registered as an organization entity type.

The provider's business location address is:

53 HARTFORD ST
DORCHESTER, MA
ZIP 02125-829
Phone: (617) 445-1868
Fax: (617) 445-2066

The provider's authorized official is Willard L L Basler .
The authorized official title is Administrator and has the following contact phone number (617) 445-1868.

The enumeration date for this NPI number is 8/5/2007 and was last updated on 8/5/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care Facility1027MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15508347MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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