Provider Demographics
NPI:1558995571
Name:EVERLASTING HOMECARE
Entity Type:Organization
Organization Name:EVERLASTING HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KERLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EXANTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-451-3646
Mailing Address - Street 1:1 ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-1131
Mailing Address - Country:US
Mailing Address - Phone:781-451-3646
Mailing Address - Fax:781-451-3644
Practice Address - Street 1:1 ADDISON AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-1131
Practice Address - Country:US
Practice Address - Phone:781-451-3646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health