MEDICARE: EVERBLESS AUTISM AND BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1316887219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERBLESS AUTISM AND BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	12266 MAIN CAMPUS DR
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-8639
Country	:	US
Telephone Number	:	617-765-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	12266 MAIN CAMPUS DR
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02421-8639
Country	:	US
Telephone Number	:	617-765-7333
Fax Number	:

Authorized Official
Title or Position	:	BCBA/CHIEF EXECUTIVE OFFICER
Name	:	BLESSING EMMANUEL
Credential	:
Telephone Number	:	617-765-7333

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	03/30/2026

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