Provider Demographics
NPI:1578218566
Name:EVERLAST HOSPICE CARE SERVICES INC
Entity Type:Organization
Organization Name:EVERLAST HOSPICE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN HORMOZI
Authorized Official - Middle Name:
Authorized Official - Last Name:BORASHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-860-4960
Mailing Address - Street 1:13021 N 35TH AVE
Mailing Address - Street 2:STE B16-4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029
Mailing Address - Country:US
Mailing Address - Phone:818-860-4960
Mailing Address - Fax:
Practice Address - Street 1:13021 N 35TH AVE
Practice Address - Street 2:STE B16-4
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:818-860-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based