Evergreen Afc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

EVERGREEN AFC

Practice address

5 King Arthur Rd
Shrewsbury, MA 01545-7750

Phone

(603) 320-0732

NPI assigned

Jul 18, 2022

Organization subpart

No

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

Authorized official

Name

Gautam Shah

Title

Owner

Phone

(603) 320-0732

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1639804347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KING ARTHUR RD",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015457750",
            "telephone_number": "603-320-0732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 KING ARTHUR RD",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015457750",
            "telephone_number": "603-320-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN AFC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "GAUTAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-320-0732"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Shrewsbury, MA
• Providers in Shrewsbury, MA by specialty
• Adult Care Home Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.