Provider Demographics
NPI:1922574763
Name:EVERCARE LLC
Entity Type:Organization
Organization Name:EVERCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:NJI
Authorized Official - Last Name:FONJOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-503-2702
Mailing Address - Street 1:6203 BEACHWAY DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-1401
Mailing Address - Country:US
Mailing Address - Phone:301-503-2702
Mailing Address - Fax:
Practice Address - Street 1:6203 BEACHWAY DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-1401
Practice Address - Country:US
Practice Address - Phone:301-503-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health