Provider Demographics
NPI:1629893359
Name:EVERCARE INC.
Entity type:Organization
Organization Name:EVERCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IDRIS
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:ABDULLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-688-9365
Mailing Address - Street 1:13944 EDGEWOOD AVE UNIT 212
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-1233
Mailing Address - Country:US
Mailing Address - Phone:952-688-9365
Mailing Address - Fax:
Practice Address - Street 1:13944 EDGEWOOD AVE UNIT 212
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-1233
Practice Address - Country:US
Practice Address - Phone:952-688-9365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center