Basic Information
| Provider Information | |||||||||
| NPI: | 1295000628 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EVERCARE HOSPICE, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | EVERCARE HOSPICE AND PALLIATIVE CARE INPATIENT UNIT | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9900 BREN RD E | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MINNETONKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553439664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037142377 | ||||||||
| FaxNumber: | 3037142396 | ||||||||
| Practice Location | |||||||||
| Address1: | 2140 POGUE AVE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452083234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136824040 | ||||||||
| FaxNumber: | 8888108182 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2012 | ||||||||
| LastUpdateDate: | 03/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | FORD | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | ALYCE | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 3037142377 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 0158HSP | OH | Y | Agencies | Hospice Care, Community Based |
No ID Information.