Provider Demographics
NPI:1558505578
Name:EVERLY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:EVERLY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:F
Authorized Official - Last Name:EVERLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-684-2510
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:GREEN MOUNTAIN FALLS
Mailing Address - State:CO
Mailing Address - Zip Code:80819-0035
Mailing Address - Country:US
Mailing Address - Phone:719-684-2510
Mailing Address - Fax:719-684-2510
Practice Address - Street 1:10730 OLATHE STREET
Practice Address - Street 2:
Practice Address - City:GREEN MOUNTAIN FALLS
Practice Address - State:CO
Practice Address - Zip Code:80819
Practice Address - Country:US
Practice Address - Phone:719-684-2510
Practice Address - Fax:719-684-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health