NPIMap

Organization Active NPI

Evergreen Behavioral LLC

  • Substance Abuse Rehabilitation Facility
  • Woburn, MA
National Provider Identifier
1609355668
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
0212 Issued in MA
Legal business name
EVERGREEN BEHAVIORAL LLC
Practice address
53 Cummings Park
Woburn, MA 01801-2123
Phone
(339) 999-2722
NPI assigned
Aug 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

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

Authorized official

Name
Pierce Michael Aliberti
Title
Co-Owner
Phone
(781) 572-2578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 0212 MA Primary

Addresses

Primary practice location

53 Cummings Park
Woburn, MA 01801-2123

Mailing address

53 Cummings Park
Woburn, MA 01801-2123

Other names 1

  • Woburn Wellness Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1609355668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012123",
            "telephone_number": "339-999-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN BEHAVIORAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "ALIBERTI",
        "authorized_official_first_name": "PIERCE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "781-572-2578"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MA",
            "license": "0212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woburn Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.