Provider Demographics
NPI:1558115386
Name:EVERMORE HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:EVERMORE HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-204-8506
Mailing Address - Street 1:12554 W DESERT ROSE RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-7013
Mailing Address - Country:US
Mailing Address - Phone:623-204-8506
Mailing Address - Fax:
Practice Address - Street 1:12554 W DESERT ROSE RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-7013
Practice Address - Country:US
Practice Address - Phone:623-204-8506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care