Evergreen Homecare LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

EVERGREEN HOMECARE LLC

Practice address

8156 Rainwater Cir
Manassas, VA 20111-5231

Phone

(267) 990-3019

NPI assigned

Sep 20, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joyce Boafo

Title

Owner

Phone

(833) 711-4299

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prince Boafo

  • Home Health Aide
  • Manassas, VA
  • NPI 1780478149
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1093593048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BOHEMIAN DR",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197099281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8156 RAINWATER CIR",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201115231",
            "telephone_number": "267-990-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "BOAFO",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-711-4299"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Renee Estridge, OTR/L
• Edward H Estrin, MD
• Eugene J Louieng, MD, PC
• Eugene Mental Health Services PLLC
• Eunice Song, DDS, PC
• Evergreen Neurology and Sleep Center
• Deborah Sue Everist
• Chizimako Margaret Eze, NP
• Carlos Fagbenro, NP
• Mary Lou Fahey, LCSW

• Nursing Care Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• Nursing Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.