Provider Demographics
NPI: | 1003143058 |
---|---|
Name: | EVEROSE HEALTHCARE, INC. |
Entity Type: | Organization |
Organization Name: | EVEROSE HEALTHCARE, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/CEO/ADMIN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TED |
Authorized Official - Middle Name: | DIEP |
Authorized Official - Last Name: | NGUYEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 713-783-1511 |
Mailing Address - Street 1: | 10440 WESTOFFICE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77042-5309 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-783-1511 |
Mailing Address - Fax: | 713-783-1530 |
Practice Address - Street 1: | 10440 WESTOFFICE DR |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77042-5309 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-783-1511 |
Practice Address - Fax: | 713-783-1530 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-11-12 |
Last Update Date: | 2020-09-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Multi-Specialty |
No | 251E00000X | Agencies | Home Health |