Healthcare Provider Details

I. General information

NPI: 1235033010
Provider Name (Legal Business Name): EVERBLOOM CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12128 PAPER BIRCH LN
GAINESVILLE VA
20155
US

IV. Provider business mailing address

2700 NEABSCO COMMON PL STE 101
WOODBRIDGE VA
22191-6767
US

V. Phone/Fax

Practice location:
  • Phone: 425-628-4284
  • Fax:
Mailing address:
  • Phone: 425-628-4284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NILAM GUPTA
Title or Position: OWNER/PRESIDENT
Credential: PRESIDENT
Phone: 425-628-4284