Provider Demographics
NPI:1770136632
Name:EVERLASTING ARMS GROUP LLC
Entity type:Organization
Organization Name:EVERLASTING ARMS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-388-2318
Mailing Address - Street 1:43644 ARBORVIEW LN
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48111-3347
Mailing Address - Country:US
Mailing Address - Phone:855-929-4368
Mailing Address - Fax:734-796-2263
Practice Address - Street 1:43644 ARBORVIEW LN
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-3347
Practice Address - Country:US
Practice Address - Phone:855-929-4368
Practice Address - Fax:734-796-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No177F00000XOther Service ProvidersLodgingGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICV0154164OtherSIGMA