Epiphany Wellness Massachusetts LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

EPIPHANY WELLNESS MASSACHUSETTS LLC

Practice address

257 Turnpike Rd Ste 200
Southborough, MA 01772-1791

Phone

(848) 221-0297

NPI assigned

Jul 30, 2024

Organization subpart

No

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

Authorized official

Name

Patrick Denglegi

Title

Vice President

Phone

(848) 221-0297

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1679302517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 TURNPIKE RD STE 200",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 TURNPIKE RD STE 200",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721791",
            "telephone_number": "848-221-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY WELLNESS MASSACHUSETTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "DENGLEGI",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "848-221-0297"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William M Egan, DMD
• Brooke K Eliopoulos
• Ellyn M Ellis, M.S., B.C.B.A.
• Jennifer Catherine Engel, MSED, BCBA
• Enlightened Psychiatry, LLC
• Ibari Ezekwe
• Brendan Falk
• Jeffrey James Farrell, ATC
• Stacey Panagotopulos Federico, PHD,RD
• William Zachary Fenn, D.P.M.

• Substance Abuse Rehabilitation Facility in Southborough, MA
• Providers in Southborough, MA by specialty
• Substance Abuse Rehabilitation Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.