Basic Information
| Provider Information | |||||||||
| NPI: | 1801458781 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FOREVER HEALTHCARE INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2924 KNIGHT ST STE 426 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711052414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184533895 | ||||||||
| FaxNumber: | 3187790439 | ||||||||
| Practice Location | |||||||||
| Address1: | 2924 KNIGHT ST STE 426 | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711052414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184533895 | ||||||||
| FaxNumber: | 3187790439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2019 | ||||||||
| LastUpdateDate: | 07/01/2019 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BARTLEY | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
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| AuthorizedOfficialTitleorPosition: | C.E.O. | ||||||||
| AuthorizedOfficialTelephone: | 3184533895 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.