Provider Demographics
NPI:1104261833
Name:EVERAH ENTERPRISES LLC
Entity type:Organization
Organization Name:EVERAH ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CICELY
Authorized Official - Middle Name:RICHEL
Authorized Official - Last Name:EVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNPM
Authorized Official - Phone:302-275-6879
Mailing Address - Street 1:109 CHESTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-1220
Mailing Address - Country:US
Mailing Address - Phone:302-275-6879
Mailing Address - Fax:
Practice Address - Street 1:109 CHESTERFIELD DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1220
Practice Address - Country:US
Practice Address - Phone:302-275-6879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77182175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty