Provider Demographics
NPI:1497488464
Name:EVERCARE HOME SERVICES, LLC
Entity Type:Organization
Organization Name:EVERCARE HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:MUSA
Authorized Official - Last Name:DUKULY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, BBA
Authorized Official - Phone:612-600-9696
Mailing Address - Street 1:6730 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-1603
Mailing Address - Country:US
Mailing Address - Phone:612-600-9696
Mailing Address - Fax:
Practice Address - Street 1:6730 5TH ST N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-1603
Practice Address - Country:US
Practice Address - Phone:612-600-9696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health