Provider Demographics
NPI:1013141472
Name:EVERCARE
Entity Type:Organization
Organization Name:EVERCARE
Other - Org Name:VISIONS FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:B
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, BCBA
Authorized Official - Phone:804-732-4281
Mailing Address - Street 1:46090 LAKE CENTER PLZ
Mailing Address - Street 2:SUITE 206-D
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5876
Mailing Address - Country:US
Mailing Address - Phone:804-732-4281
Mailing Address - Fax:804-862-2644
Practice Address - Street 1:46090 LAKE CENTER PLZ
Practice Address - Street 2:SUITE 206-D
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5876
Practice Address - Country:US
Practice Address - Phone:804-732-4281
Practice Address - Fax:804-862-2644
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISIONS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA49805001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health