Provider Demographics
NPI:1710471354
Name:EVERLASTING LOVE HOMECARE AND PRIVATE DUTY SERVICES, L.L.C.
Entity Type:Organization
Organization Name:EVERLASTING LOVE HOMECARE AND PRIVATE DUTY SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-396-3532
Mailing Address - Street 1:1450 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-3162
Mailing Address - Country:US
Mailing Address - Phone:859-685-2193
Mailing Address - Fax:877-333-9585
Practice Address - Street 1:1450 N BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-3162
Practice Address - Country:US
Practice Address - Phone:859-685-2193
Practice Address - Fax:877-333-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500300253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care