Gifford Street Wellness Center, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

GIFFORD STREET WELLNESS CENTER, LLC

Doing business as

Gifford Street Wellness Center

Practice address

34 Gifford Street
New Bedford, MA 02744-2610

Phone

(508) 999-3126

Fax

(508) 991-8409

NPI assigned

Sep 17, 2020

Organization subpart

Yes

Parent organization

ACADIA HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Brian Phillip Farley

Title

VP & Secretary

Phone

(615) 861-6000

Specialties & licenses 1

Addresses

Other names 1

• Gifford Street Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Gifford Street Wellness Center, LLC

  • Methadone Clinic
  • New Bedford, MA
  • NPI 1891142154

  3274811120

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Gifford Street Wellness Center, LLC

  • Methadone Clinic
  • New Bedford, MA
  • NPI 1891142154

  O20200303000789

  Same enrollment

Part of

Haven Behavioral Healthcare

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Clarksburg Treatment Center, LLC

  • Methadone Clinic
  • Clarksburg, WV
  • NPI 1124533930

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Acadia Healthcare

  • Addiction (Substance Use Disorder) Counselor
  • Boston, MA
  • NPI 1457704116
  NPPES parent name

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1568078327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6183 PASCO DEL NORTE, STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111155",
            "telephone_number": "855-259-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 GIFFORD STREET",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027442610",
            "telephone_number": "508-999-3126",
            "fax_number": "508-991-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIFFORD STREET WELLNESS CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACADIA HEALTHCARE",
        "enumeration_date": "2020-09-17",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gifford Street Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten Gibbs
• Cayla Elizabeth Giblin, MA
• Erica Marie-Ange Gibson, PHARMD
• Elizabeth D. Giddings, M.A.
• Krishna Gidwani, COF, CDME
• Gifford Street Wellness Center, LLC
• Corey Gifford, PSY.D.
• Sarah Gifford
• Giga Med I LLC
• Gilbert L. Shapiro, M.D. Facs PC

• Methadone Clinic in New Bedford, MA
• Providers in New Bedford, MA by specialty
• Methadone Clinic in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.