NPIMap

Organization Active NPI

Lutheran Home of Jamaica Plain, Inc.

  • Skilled Nursing Facility
  • Jamaica Plain, MA
National Provider Identifier
1972039113
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LUTHERAN HOME OF JAMAICA PLAIN, INC.
Practice address
174 Forest Hills St
Jamaica Plain, MA 02130-3353
Phone
(617) 522-1550
NPI assigned
May 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Authorized official

Name
Angela Bovill
Title
President
Phone
(774) 243-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

174 Forest Hills St
Jamaica Plain, MA 02130-3353

Mailing address

14 E Worcester St
Suite 300
Worcester, MA 01604-3612

Other names 1

  • Laurel Ridge Rehabilitation and Skilled Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170518001260 MA Part A Provider - Skilled Nursing Facility 3375631682 Practice locations: Boston, MA

Skilled nursing facility certification: CCN 225469

Legal name
LUTHERAN HOME OF JAMAICA PLAIN INC
Doing business as
LAUREL RIDGE REHABILITATION AND SKILLED CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1990
Last certification
May 21, 2025
Beds
120
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Ascentria Care Alliance
Most recent change of ownership
Jun 12, 2017
Organization structure
CorporationNon-profit
Enrollment address
174 Forest Hills St
Boston, MA 02130-3353
Nursing home name
LAUREL RIDGE REHAB AND SKILLED CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Laurel Ridge Rehab and Skilled Care CenterCCN 225469
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120109.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Jamaica Plain Health Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

14 E Worcester St
Ste 300
Worcester, MA 01604

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
Kristin Hanscom Individual Corporate OfficerChief Financial Officer Sep 1, 2023 5%
Adp of the SNF Sep 1, 2023
Keith Robertson Individual Corporate Director Jan 1, 2024
Ascentria Care Alliance Inc Organization, Worcester, MA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 10, 2017 100%
Adp of the SNF Mar 26, 2025
Nicholas Sousa Individual Corporate Director Jan 1, 2024
Adp of the SNF Jan 1, 2024
Hassan Arif Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Nicholas Russo Individual Corporate Director Jun 10, 2017
William T Mayo Individual Corporate DirectorDirector Jun 10, 2017
Alexander Bartholomew Individual Corporate Director Jan 1, 2024
Ashish Cowlagi Individual Corporate Director Jan 1, 2024
Ross S Goodman Individual Corporate Director Jan 1, 2024
Gary Oneal Individual Corporate Director Jan 1, 2024
Angela B Bovill Individual Corporate OfficerPresident Jun 10, 2017 5%
Operational/Managerial Control Jun 10, 2017
Adp of the SNF Jun 10, 2017
Tara Browne Individual Corporate Director Jan 1, 2024
Adp of the SNF Jan 1, 2024
Colin Oleary Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024

Owners & managing parties with NPI records 1

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

  • Hassan Arif, MD
    • Geriatric Medicine (Internal Medicine) Physician
    • Roslindale, MA
    • NPI 1376775130

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

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 2

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": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1972039113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E WORCESTER ST",
            "address_2": "SUITE 300",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 FOREST HILLS ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303353",
            "telephone_number": "617-522-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN HOME OF JAMAICA PLAIN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "BOVILL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "774-243-3900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Ridge Rehabilitation and Skilled Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.