MEDICARE: EVERCARE SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194617456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERCARE SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	5528 BIRCHLAND CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-3003
Country	:	US
Telephone Number	:	614-928-5435
Fax Number	:

Provider Business Practice Location Address
First Line	:	5528 BIRCHLAND CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-3003
Country	:	US
Telephone Number	:	614-928-5435
Fax Number	:	614-928-5435

Authorized Official
Title or Position	:	CEO
Name	:	MS. IFRAH HIRSI HASSAN
Credential	:
Telephone Number	:	614-928-5435

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	07/18/2025

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