Provider Demographics
NPI:1104200674
Name:EVERLINES LOVING ARMS, LLC
Entity Type:Organization
Organization Name:EVERLINES LOVING ARMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TEMEKA
Authorized Official - Middle Name:LESHEA
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-965-0343
Mailing Address - Street 1:102 BELLEVUE ST
Mailing Address - Street 2:1000
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-9512
Mailing Address - Country:US
Mailing Address - Phone:318-965-0343
Mailing Address - Fax:318-965-0353
Practice Address - Street 1:102 BELLEVUE ST
Practice Address - Street 2:1000
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-9512
Practice Address - Country:US
Practice Address - Phone:318-965-0343
Practice Address - Fax:318-965-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782330253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care