MEDICARE: BOSTON 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
1	314000000X	Skilled Nursing Facility	0463	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1811990930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON HOME INC

Provider Business Mailing Address
First Line	:	2049 DORCHESTER AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02124-4742
Country	:	US
Telephone Number	:	617-825-3905
Fax Number	:	617-825-1951

Provider Business Practice Location Address
First Line	:	2049 DORCHESTER AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02124-4742
Country	:	US
Telephone Number	:	617-825-3905
Fax Number	:	617-825-1951

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. CHRISTINE REILLY
Credential	:	LNHA
Telephone Number	:	617-326-4265

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/01/2020

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Directions to “BOSTON HOME INC ” Practice Location

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