Provider Demographics
NPI:1467683813
Name:4 EVER BLESSED HOMECARE
Entity Type:Organization
Organization Name:4 EVER BLESSED HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMEY
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:336-303-2517
Mailing Address - Street 1:2531 CORINTH DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-4783
Mailing Address - Country:US
Mailing Address - Phone:336-303-2517
Mailing Address - Fax:
Practice Address - Street 1:2531 CORINTH DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-4783
Practice Address - Country:US
Practice Address - Phone:336-303-2517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care