Provider Demographics
NPI:1720409543
Name:EVERLASTING CARE SERVICES LLC
Entity Type:Organization
Organization Name:EVERLASTING CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADENIKE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MODILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2254-462-8970
Mailing Address - Street 1:1353 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-0000
Mailing Address - Country:US
Mailing Address - Phone:254-462-8970
Mailing Address - Fax:
Practice Address - Street 1:1353 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0000
Practice Address - Country:US
Practice Address - Phone:254-462-8970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health