Provider Demographics
NPI:1952614448
Name:EVERO CORPORATION
Entity Type:Organization
Organization Name:EVERO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-750-4483
Mailing Address - Street 1:181 HILLSIDE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1746
Mailing Address - Country:US
Mailing Address - Phone:516-747-4200
Mailing Address - Fax:516-747-8383
Practice Address - Street 1:181 HILLSIDE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1746
Practice Address - Country:US
Practice Address - Phone:516-747-4200
Practice Address - Fax:516-747-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03234911Medicaid