Provider Demographics
NPI:1588968531
Name:EVERCARE HOME ASSISTED LIVING HOME
Entity type:Organization
Organization Name:EVERCARE HOME ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUDIVINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:NAVIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:907-865-7931
Mailing Address - Street 1:5040 KNIGHTS WAY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4810
Mailing Address - Country:US
Mailing Address - Phone:907-865-7931
Mailing Address - Fax:907-865-7931
Practice Address - Street 1:5040 KNIGHTS WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4810
Practice Address - Country:US
Practice Address - Phone:907-865-7931
Practice Address - Fax:907-865-7931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100828310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility