Provider Demographics
NPI:1902440068
Name:EVA'S AFC HOME, LLC
Entity Type:Organization
Organization Name:EVA'S AFC HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:K'LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FELTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-792-5112
Mailing Address - Street 1:3151 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MI
Mailing Address - Zip Code:49419-9548
Mailing Address - Country:US
Mailing Address - Phone:731-792-5112
Mailing Address - Fax:
Practice Address - Street 1:3151 136TH AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MI
Practice Address - Zip Code:49419-9548
Practice Address - Country:US
Practice Address - Phone:731-792-5112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health