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General NPI Number Information
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NPI Number | 1710471354
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Entity Type | Organization
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Legal Business Name | EVERLASTING LOVE HOMECARE AND PRIVATE DUTY SERVICES, L.L.C.
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 1450 N BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40505-3162
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Country | US
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Telephone | 859-685-2193
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Fax | 877-333-9585
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Provider Business Mailing Address
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Address Line | 1450 N BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40505-3162
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Country | US
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Telephone | 859-685-2193
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Fax | 877-333-9585
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Authorized Official
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Title or Position | OWNER
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Name | MS. VELMA L GRANT
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Credential |
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Telephone | 859-396-3532
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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 | 500300
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License Number State | KY
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