Provider Demographics
NPI:1992353650
Name:EVANS HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:EVANS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LILIANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTHE NCHAKO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:770-837-9343
Mailing Address - Street 1:7495 COVINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-7664
Mailing Address - Country:US
Mailing Address - Phone:770-837-9343
Mailing Address - Fax:770-674-0635
Practice Address - Street 1:7495 COVINGTON HWY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-7664
Practice Address - Country:US
Practice Address - Phone:770-837-9343
Practice Address - Fax:770-674-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health