Provider Demographics
NPI:1104653633
Name:EVERCARE INC
Entity type:Organization
Organization Name:EVERCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IMOMOTIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYEEQUAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-364-6462
Mailing Address - Street 1:33 W FRANKLIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 W FRANKLIN ST STE 2
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4826
Practice Address - Country:US
Practice Address - Phone:301-364-6462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health