NPIMap

Organization Active NPI

Lutheran Housing Corporation - Brockton

  • Skilled Nursing Facility
  • Worcester, MA
National Provider Identifier
1770158438
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LUTHERAN HOUSING CORPORATION - BROCKTON
Practice address
26 Harvard St
Worcester, MA 01609-2833
Phone
(508) 450-1857
NPI assigned
May 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Angela Bovill
Title
Ceo
Phone
(774) 243-3932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

26 Harvard St
Worcester, MA 01609-2833

Mailing address

26 Harvard St
Worcester, MA 01609-2833
Phone (508) 450-1857

Other names 1

  • Lutheran Rehabilitation and Skilled Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL lmcdonnell@ascentria.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210721000087 MA Part A Provider - Skilled Nursing Facility 5496158057 Practice locations: Worcester, MA

Skilled nursing facility certification: CCN 225379

Legal name
LUTHERAN HOUSING CORPORATION - BROCKTON
Doing business as
LUTHERAN REHABILITATION AND SKILLED CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 25, 1996
Last certification
Aug 20, 2024
Beds
150
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Ascentria Care Alliance
Organization structure
CorporationNon-profit
Incorporated
Jun 23, 1987 in MA
Enrollment address
26 Harvard St
Worcester, MA 01609-2833
Nursing home name
LUTHERAN REHABILITATION AND SKILLED CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lutheran Rehabilitation and Skilled Care CenterCCN 225379
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 25, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
15099.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Allison M Hargreaves Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Kristin Hanscom Individual Corporate OfficerChief Financial Officer Sep 1, 2023
Adp of the SNF Sep 1, 2023
Keith Robertson Individual Corporate Director Jul 15, 2021
Ascentria Care Alliance Inc Organization, Worcester, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 15, 2021 100%
Adp of the SNF Apr 1, 2025
Nicholas Sousa Individual Corporate Director Jul 15, 2021
Adp of the SNF Jul 15, 2021
Nicholas Russo Individual Corporate OfficerTreasurer Jan 1, 2024 100%
Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
William T Mayo Individual Corporate DirectorDirector Jul 15, 2021
Alexander Bartholomew Individual Corporate Director Jul 15, 2021
Robin High Individual Operational/Managerial Control Jul 15, 2021
Adp of the SNF Jul 15, 2021
Ashish Cowlagi Individual Corporate Director Jul 15, 2021
Ross S Goodman Individual Corporate DirectorDirector Jul 15, 2021
Gary Oneal Individual Corporate Director Jan 1, 2025
Angela B Bovill Individual Corporate OfficerPresident/Ceo Jul 15, 2021
Corporate DirectorCeo Jul 15, 2021
Adp of the SNF Jul 15, 2021
Tara Browne Individual Corporate OfficerOfficer Jul 15, 2021
Adp of the SNF Jul 15, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1770158438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092833",
            "telephone_number": "508-450-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092833",
            "telephone_number": "508-450-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOUSING CORPORATION - BROCKTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "BOVILL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "774-243-3932"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lmcdonnell@ascentria.org",
            "affiliation": "N",
            "endpointDescription": "Work Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "26 Harvard St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016092833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lutheran Rehabilitation and Skilled Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lutheran Rehabilitation and Skilled Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.