MEDICARE: EVERCARE COMFORT 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	:	1437983731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERCARE COMFORT LLC

Provider Business Mailing Address
First Line	:	2720 QUEEN CITY AVE APT 11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2633
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 QUEEN CITY AVE APT 11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2633
Country	:	US
Telephone Number	:	513-264-3870
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA MARIE JOHNSON
Credential	:
Telephone Number	:	513-264-3870

Provider Enumeration Date	:	08/28/2024
Last Update Date	:	04/26/2025

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