NPIMap

Organization Active NPI

Broad Reach of Chatham Inc.

Doing business as Liberty Commons Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • N Chatham, MA
National Provider Identifier
1497748735
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0884 Issued in MA
Legal business name
BROAD REACH OF CHATHAM INC.
Doing business as
Liberty Commons Nursing & Rehabilitation Center
Practice address
390 Orleans Rd
N Chatham, MA 02650-1154
Phone
(508) 945-4611
Fax
(508) 945-2245
NPI assigned
Aug 23, 2005
Last updated
Mar 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William J Bogdanovich, CNHA
Title
President/Ceo
Phone
(508) 945-4611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0884 MA Primary

Addresses

Primary practice location

390 Orleans Rd
N Chatham, MA 02650-1154

Mailing address

390 Orleans Rd
N Chatham, MA 02650-1154
Phone (508) 945-4611

Other names 1

  • Liberty Commons Nursing & Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000505 MA Part A Provider - Skilled Nursing Facility 0648183459 Practice locations: North Chatham, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497748735. Details of each certification follow.

Skilled nursing facility certification: CCN 225330

Legal name
BROAD REACH OF CHATHAM INC
Doing business as
LIBERTY COMMONS NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 2, 1989
Last certification
Sep 11, 2024
Beds
132
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Enrollment address
390 Orleans Road
North Chatham, MA 02650-1154
Nursing home name
LIBERTY COMMONS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Liberty CommonsCCN 225330 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 2, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
132126.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Broad Reach of Chatham Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jason Lavallee Individual Operational/Managerial ControlAdministrator Feb 1, 2022 100%
Adp of the SNF Feb 1, 2022
Christopher Jones Individual Operational/Managerial ControlChief Operating Officer Jan 1, 2022 100%
Donna Lahaie Individual Operational/Managerial ControlChief Financial Officer Jan 7, 2021 100%
Individual Adp of the SNF Jun 18, 2023
Organization, North Chatham, MA LLC Adp of the SNF Jul 27, 1996
Organization, Stuart, FL LLC Adp of the SNF Apr 12, 2025
Organization, Bethesda, MD LLC Adp of the SNF Apr 12, 2025
Organization, Southborough, MA Corporation Adp of the SNF Jan 1, 2025
William J Bogdanovich Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Nov 12, 2012 100%
Corporate OfficerPresident, Treasurer, Ceo Nov 9, 2012 100%
Corporate Director Dec 12, 2005
Operational/Managerial Control Feb 1, 1987
Managing Control - Governing BodyPresident/Ceo Nov 9, 2012
Adp of the SNF Feb 1, 1987
Organization, Minneapolis, MN LLC, For-profit Adp of the SNF May 21, 2025
Eric a Weber Individual Operational/Managerial ControlMedical Director Jun 28, 2004
Adp of the SNF Feb 6, 2022
Individual Adp of the SNF Jun 18, 2018
Individual Adp of the SNF May 22, 2006

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 21

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1497748735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 ORLEANS RD",
            "city": "N CHATHAM",
            "state": "MA",
            "postal_code": "026501154",
            "telephone_number": "508-945-4611",
            "fax_number": "508-945-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ORLEANS RD",
            "city": "N CHATHAM",
            "state": "MA",
            "postal_code": "026501154",
            "telephone_number": "508-945-4611",
            "fax_number": "508-945-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD REACH OF CHATHAM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "BOGDANOVICH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "508-945-4611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Commons Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.