Provider Demographics
NPI:1265221329
Name:EVER GREEN HOME CARE LLC
Entity type:Organization
Organization Name:EVER GREEN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:BOSEDE
Authorized Official - Last Name:AYENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-647-7236
Mailing Address - Street 1:4780 I 55 N SUITE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON MS
Mailing Address - State:MS
Mailing Address - Zip Code:39211
Mailing Address - Country:US
Mailing Address - Phone:855-647-7236
Mailing Address - Fax:310-245-6398
Practice Address - Street 1:4780 I 55 N SUITE 100
Practice Address - Street 2:
Practice Address - City:JACKSON MS
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:855-647-7236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care