Provider Demographics
NPI:1902173511
Name:EVERLASTING HOSPICE INC.
Entity Type:Organization
Organization Name:EVERLASTING HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:U
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-769-3700
Mailing Address - Street 1:11758 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-1626
Mailing Address - Country:US
Mailing Address - Phone:773-769-3700
Mailing Address - Fax:773-769-3700
Practice Address - Street 1:11758 ORCHARD RD
Practice Address - Street 2:
Practice Address - City:WILLOW SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60480-1626
Practice Address - Country:US
Practice Address - Phone:773-769-3700
Practice Address - Fax:773-769-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based