Healthcare Provider Details

I. General information

NPI: 1992085211
Provider Name (Legal Business Name): EVERLASTING HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2834 HIGHWAY AVE
HIGHLAND IN
46322-1629
US

IV. Provider business mailing address

2158 45TH ST STE 519
HIGHLAND IN
46322-3742
US

V. Phone/Fax

Practice location:
  • Phone: 630-430-4762
  • Fax:
Mailing address:
  • Phone: 219-670-3148
  • Fax: 219-844-3578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER CHALOKWU
Title or Position: OWNER
Credential: PHD
Phone: 630-430-4762