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General NPI Number Information
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NPI Number | 1770136632
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Entity Type | Organization
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Legal Business Name | EVERLASTING ARMS GROUP LLC
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 43644 ARBORVIEW LN
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-3347
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Country | US
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Telephone | 855-929-4368
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Fax | 734-796-2263
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Provider Business Mailing Address
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Address Line | 43644 ARBORVIEW LN
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-3347
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Country | US
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Telephone | 855-929-4368
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Fax | 734-796-2263
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | ABRAHAM O'DARE
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Credential |
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Telephone | 312-388-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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