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General NPI Number Information
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NPI Number | 1487792339
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Entity Type | Organization
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Legal Business Name | EVERCARE HOME HEALTH & HOSPICE, INC.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 10808 RIVER FRONT PARKWAY SUITE 398
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5761
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Country | US
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Telephone | 801-984-8089
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Fax | 801-984-4320
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Provider Business Mailing Address
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Address Line | 10808 RIVER FRONT PARKWAY SUITE 398
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-5761
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Country | US
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Telephone | 801-984-8089
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Fax | 801-984-4320
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LANCE J SQUIRE
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Credential |
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Telephone | 801-608-5493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2006-HHA-42584
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 2006-HOSPICE-67400
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 2009-HOSPICE-90210
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2009-HHA-90252
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License Number State | UT
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