=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245227578
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERYAGE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2005
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 102 LEONARD AVE
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28658-9649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-464-8260
-----------------------------------------------------
Fax | 828-465-8573
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 LEONARD AVE
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28658-9649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-464-8264
-----------------------------------------------------
Fax | 828-465-8573
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND CEO
-----------------------------------------------------
Name | LEE B SYRIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 828-465-8019
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | NH0191
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------