Provider Demographics
NPI:1912778333
Name:EVERCARE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:EVERCARE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:EKEABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-263-0752
Mailing Address - Street 1:4928 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-1222
Mailing Address - Country:US
Mailing Address - Phone:856-263-0752
Mailing Address - Fax:
Practice Address - Street 1:4928 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-1222
Practice Address - Country:US
Practice Address - Phone:856-263-0752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty