Provider Demographics
NPI:1831683572
Name:EVER MERCY CARE LLC
Entity type:Organization
Organization Name:EVER MERCY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COODIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMIJIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-326-3327
Mailing Address - Street 1:18412 W MISSION LN
Mailing Address - Street 2:
Mailing Address - City:WADDELL
Mailing Address - State:AZ
Mailing Address - Zip Code:85355-4303
Mailing Address - Country:US
Mailing Address - Phone:623-666-3895
Mailing Address - Fax:623-321-1206
Practice Address - Street 1:18412 W MISSION LN
Practice Address - Street 2:
Practice Address - City:WADDELL
Practice Address - State:AZ
Practice Address - Zip Code:85355-4303
Practice Address - Country:US
Practice Address - Phone:623-666-3895
Practice Address - Fax:623-321-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ08035251G00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based