NPI Code Details Logo

NPI 1235033010

NPI 1235033010 : EVERBLOOM CARE LLC : GAINESVILLE, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1235033010
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    EVERBLOOM CARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/06/2026
-----------------------------------------------------
    Last Update Date     |    10/06/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    12128 PAPER BIRCH LN 
-----------------------------------------------------
    City                 |    GAINESVILLE
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    20155
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    425-628-4284
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2700 NEABSCO COMMON PL STE 101 
-----------------------------------------------------
    City                 |    WOODBRIDGE
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    22191-6767
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    425-628-4284
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER/PRESIDENT
-----------------------------------------------------
    Name                 |     NILAM  GUPTA 
-----------------------------------------------------
    Credential           |    PRESIDENT
-----------------------------------------------------
    Telephone            |    425-628-4284
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    NULL
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.