Provider Demographics
NPI:1962712950
Name:EVERCARE, LLC
Entity type:Organization
Organization Name:EVERCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-660-6849
Mailing Address - Street 1:410 RICHARDS AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3635
Mailing Address - Country:US
Mailing Address - Phone:307-660-6849
Mailing Address - Fax:
Practice Address - Street 1:410 RICHARDS AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3635
Practice Address - Country:US
Practice Address - Phone:307-660-6849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY21260163W00000X, 163WH0200X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty