Provider Demographics
NPI:1205246022
Name:EVEREADY HOME CARE, LLC
Entity type:Organization
Organization Name:EVEREADY HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSING DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:OWUSU
Authorized Official - Last Name:OBENG
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:703-496-4300
Mailing Address - Street 1:17902 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2466
Mailing Address - Country:US
Mailing Address - Phone:703-496-4300
Mailing Address - Fax:855-256-4003
Practice Address - Street 1:17902 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2466
Practice Address - Country:US
Practice Address - Phone:703-496-4300
Practice Address - Fax:855-256-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-14719251B00000X, 251F00000X, 251J00000X, 261QP2000X, 385H00000X, 251E00000X
VAHCO14719252Y00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1477867414Medicaid