Provider Demographics
NPI:1063276517
Name:EVERCARE RESPITE LLC
Entity type:Organization
Organization Name:EVERCARE RESPITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:BRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-381-1851
Mailing Address - Street 1:4922 OLD PAGE RD APT 802
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8459
Mailing Address - Country:US
Mailing Address - Phone:919-381-8351
Mailing Address - Fax:919-237-2603
Practice Address - Street 1:4922 OLD PAGE RD APT 802
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8459
Practice Address - Country:US
Practice Address - Phone:919-381-8351
Practice Address - Fax:919-237-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health