Provider Demographics
NPI:1124015458
Name:EVERYAGE
Entity Type:Organization
Organization Name:EVERYAGE
Other - Org Name:PIEDMONT CROSSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTS REC MGR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:SUTTON
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-465-8021
Mailing Address - Street 1:100 HEDRICK DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-6009
Mailing Address - Country:US
Mailing Address - Phone:336-472-2017
Mailing Address - Fax:336-474-3895
Practice Address - Street 1:100 HEDRICK DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-6009
Practice Address - Country:US
Practice Address - Phone:336-472-2017
Practice Address - Fax:336-474-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0390314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801526Medicaid
NC3406367Medicaid
NC3405310Medicaid
NC3405310Medicaid