Provider Demographics
NPI:1548308869
Name:EVERWELL HEALTH AGENCY, LLC
Entity type:Organization
Organization Name:EVERWELL HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:LLAVORE
Authorized Official - Last Name:CLEMENTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-782-2114
Mailing Address - Street 1:1015 MESA VERDE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1501
Mailing Address - Country:US
Mailing Address - Phone:972-678-0529
Mailing Address - Fax:972-678-0529
Practice Address - Street 1:1015 MESA VERDE
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1501
Practice Address - Country:US
Practice Address - Phone:972-678-0529
Practice Address - Fax:972-678-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health