South Boston Nursing LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0458 Issued in MA

Legal business name

SOUTH BOSTON NURSING LLC

Doing business as

Harborlights Rehab and Nursing Center

Practice address

804 E 7TH St
South Boston, MA 02127-4346

Phone

(617) 268-8968

NPI assigned

Jan 16, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brad Rolph

Title

Cfo

Phone

(781) 297-8626

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Harborlights Rehab and Nursing Center Doing business as

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740269893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KERRY PL",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624775",
            "telephone_number": "781-619-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E 7TH ST",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021274346",
            "telephone_number": "617-268-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BOSTON NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROLPH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "781-297-8626",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MA",
            "license": "0458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0926108",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harborlights Rehab and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Boston Community Health Center
• South Boston Community Health Center
• South Boston Community Health Center
• South Boston Dental Associates
• South Boston Family Dental LLC
• Rachel Souza, DO
• Virginia Stalnaker, DPT
• Sophia Kay Struzziero
• Alexandra Sullivan
• Amanda Marie Sullivan, RN

• Skilled Nursing Facility in South Boston, MA
• Providers in South Boston, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.