MEDICARE: EVERHOPE PRIMARY HOME CARE 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
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1447000385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERHOPE PRIMARY HOME CARE LLC

Provider Business Mailing Address
First Line	:	70 MOSSY CREEK PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-6132
Country	:	US
Telephone Number	:	956-203-5885
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 MOSSY CREEK PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-6132
Country	:	US
Telephone Number	:	956-203-5885
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUNA I HORNSBY
Credential	:	MBA
Telephone Number	:	956-203-5885

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	10/29/2024

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