Evelyn'S Home Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL13064 Issued in FL

Legal business name

EVELYN'S HOME ASSISTED LIVING LLC

Practice address

2119 Beacon Landing Cir
Orlando, FL 32824-4374

Phone

(407) 497-1243

Fax

(407) 888-9121

NPI assigned

Apr 18, 2018

Organization subpart

No

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

Authorized official

Name

Florence Woberaere Ejiowhor, RNNPI 1396255139

Title

Owner/Administrator

Phone

(407) 497-1243

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Florence Woberaere Ejiowhor, RN, ADMINISTRATOR

  • Registered Nurse
  • Orlando, FL
  • NPI 1396255139
  NPD (past) Authorized official

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1104313790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 BEACON LANDING CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328244374",
            "telephone_number": "407-497-1243",
            "fax_number": "407-888-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 BEACON LANDING CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328244374",
            "telephone_number": "407-497-1243",
            "fax_number": "407-888-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN'S HOME ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "EJIOWHOR",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_middle_name": "WOBERAERE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "407-497-1243",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL13064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396255139",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022295400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rishandrea Evans
• Rory A. Evans, MD
• Samantha Evans, DPT
• Tonya Y. Evans
• Evelyn Miranda Halem, DMD, PA
• Evening Pediatrics Inc
• Portia Elizabeth Everet, COTA/L
• Chasiti Everett, RBT
• Christine A. Everett, ATC LAT
• George Douglas Everett, MD

• Assisted Living Facility in Orlando, FL
• Providers in Orlando, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.