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BURGOYNE REST HOME INC
NPI 1104017292
Nursing Facility/Intermediate Care Facility in Dorchester, MA

Active since August 05, 2007CLIA 22D2343648 · Waiver
53 HARTFORD ST, DORCHESTER, MA 02125(617) 445-1868(617) 445-2066 Get Directions Write a Review

NPPES record last updated: August 5, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Burgoyne Rest Home Inc NPPES

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

BURGOYNE REST HOME INC (NPI 1104017292) is a healthcare organization registered as a nursing facility/intermediate care facility in Dorchester, Massachusetts and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through May 10, 2028 and lists Willard L L Basler, Administrator, as its authorized official.

NPPES Registry Identity

NPI1104017292
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameBURGOYNE REST HOME INC
Location Address53 HARTFORD STDorchester, MA 02125-2829
Mailing Address53 Hartford StDorchester, MA 02125-2829 · (617) 445-1868 · Fax (617) 445-2066
Phone(617) 445-1868
Fax(617) 445-2066
Organization SubpartNo
Authorized OfficialWillard L L BaslerAdministrator · (617) 445-1868
Enumeration DateAugust 5, 2007
✔ NPI 1104017292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in MA · 1027
Definition
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.
53 HARTFORD ST, Dorchester, MA 02125
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Other Identifiers 1

Medicaid5508347MA

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 22D2343648

Wellspring Homecare Dba Burgoyne Rest Home · Dorchester, MA
Active · expires May 10, 2028
CLIA Number22D2343648
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 11, 2026
Certificate Expiration DateMay 10, 2028
Laboratory DirectorCondase Weekes-Best
Laboratory Phone(617) 445-1868
Laboratory LocationWellspring Homecare Dba Burgoyne Rest Home53 Hartford Street, Dorchester, MA 02125
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

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

WELLSPRING HOMECARE
Assisted Living Facility
53 HARTFORD ST
BOSTON, MA 02125
Suffolk County (617) 680-5779

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 Burgoyne Rest Home Inc's NPI number?

The NPI number for Burgoyne Rest Home Inc is 1104017292. It was assigned to this organization in the NPPES registry on August 5, 2007.

Where is Burgoyne Rest Home Inc located?

Burgoyne Rest Home Inc is located at 53 Hartford St, Dorchester, MA 02125. The listed phone number is (617) 445-1868.

What is Burgoyne Rest Home Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Burgoyne Rest Home Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2343648) is associated with this NPI, valid through May 10, 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 Burgoyne Rest Home Inc was last updated on August 5, 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.