Provider Demographics
NPI:1396468773
Name:4 EVER BLESSINGSHOME CARE CORP
Entity type:Organization
Organization Name:4 EVER BLESSINGSHOME CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-833-5577
Mailing Address - Street 1:200 HAWKINS AVE UNIT 1166
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-8019
Mailing Address - Country:US
Mailing Address - Phone:631-939-1901
Mailing Address - Fax:
Practice Address - Street 1:2306 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6522
Practice Address - Country:US
Practice Address - Phone:631-833-5577
Practice Address - Fax:631-615-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care