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General NPI Number Information
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NPI Number | 1285018762
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Entity Type | Organization
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Legal Business Name | EVERLINES LOVING ARMS, LLC
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 102 BELLEVUE ST 1000
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City | BENTON
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State | LA
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Zip | 71006-9512
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Country | US
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Telephone | 318-965-0343
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Fax | 318-965-0353
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Provider Business Mailing Address
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Address Line | 102 BELLEVUE ST 1000
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City | BENTON
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State | LA
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Zip | 71006-9512
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Country | US
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Telephone | 318-965-0343
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Fax | 318-965-0353
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. TEMEKA GREEN
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Credential |
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Telephone | 318-965-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2203782330
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License Number State | LA
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