Evergreen Home Assistance LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EVERGREEN HOME ASSISTANCE LLC

Doing business as

HomeWell Care Services PA261

Practice address

4302 Greensprings Ave
West Mifflin, PA 15122-1765

Phone

(631) 636-8767

NPI assigned

Jul 8, 2024

Last updated

Jul 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Theophilia Chinelo Agusibe-Akamobi, RN- BSN

Title

Owner /Ceo

Phone

(631) 636-8767

Specialties & licenses 1

Addresses

Other names 1

• HomeWell Care Services PA261 Doing business as

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1386480515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 GREENSPRINGS AVE",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151221765",
            "telephone_number": "631-636-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 GREENSPRINGS AVE",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "151221765",
            "telephone_number": "631-636-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOME ASSISTANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "AGUSIBE-AKAMOBI",
        "authorized_official_first_name": "THEOPHILIA",
        "authorized_official_middle_name": "CHINELO",
        "authorized_official_title_or_position": "OWNER /CEO",
        "authorized_official_telephone_number": "631-636-8767",
        "authorized_official_credential": "RN- BSN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeWell Care Services PA261",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edp of Pennsylvania PC (The Dentistry of West Mifflin)
• Edward W Jew III MD and Associates PC
• Anita Edwards, MD
• Kristen Ann Ehrenberger, MD, PHD
• Kurt Reiner Eichenmuller, M.D.
• Gerald Felen, DMD
• Joseph Lawrence Filippini, DDS
• Kylie Rae Fultineer, MD
• G.M. Crevar Opt Inc
• Douglas Paul Ganassi, MED - EX. SCI., ATC,

• In Home Supportive Care Agency in West Mifflin, PA
• Providers in West Mifflin, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.