Provider Demographics
NPI:1508923780
Name:ROGERSON COMMUNITIES
Entity Type:Organization
Organization Name:ROGERSON COMMUNITIES
Other - Org Name:ROGERSON COMMUNITIES ADULT DAY HEALTH PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:SEAGLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:617-469-5800
Mailing Address - Street 1:1 FLORENCE ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3638
Mailing Address - Country:US
Mailing Address - Phone:617-469-5800
Mailing Address - Fax:
Practice Address - Street 1:23 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02131-3638
Practice Address - Country:US
Practice Address - Phone:617-469-5829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1901311Medicaid