EVERSHINE CARE, LLC (NPI# 1043688088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043688088 |
| Entity Type | Organization |
| Organization Name | EVERSHINE CARE, LLC |
| Practice Address |
4844 Calle Bella Ave Las Cruces NM 88012-7066 |
| Practice Telephone | 5753825973 |
| Mailing Telephone | 5753825973 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |
| Authorized Official Name | DR. IVAN NNAMDI NWAOGU (ADMINISTRATOR) |
| Authorized Official Telephone | 5753825973 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 1T3533 | NM | Nursing & Custodial Care Facilities |
| Street Address |
4844 CALLE BELLA AVE |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88012-7066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962972588 | Ashley Ruiz | Behavior Technician | 5210 Cats Eye Road, Las Cruces, NM 88012 | 2018-11-27 |
| 1922549492 | Marisol Olivas Lmft LLC | Community/Behavioral Health | 5019 Kensington Way, Las Cruces, NM 88012 | 2017-03-16 |
| 1487026563 | Ben Archer Health Center | Clinic/Center | 3331 Del Rey Blvd., Las Cruces, NM 88012 | 2015-10-28 |
| 1003214941 | Rosa Smith | Case Manager/Care Coordinator | 5022 Calle De Ranchero, Las Cruces, NM 88012 | 2014-12-09 |
| 1891198081 | Patrick Garcia | Nurse Practitioner | 5819 Coyote Peak Place, Las Cruces, NM 88012 | 2014-10-01 |
| 1598182008 | Candido Jasso | Case Manager/Care Coordinator | 4076 Windridge Circle, Las Cruces, NM 88012 | 2014-03-21 |
| 1134542186 | Dawn Loree Schallock | Registered Nurse | 4675 Peachtree Hills Rd., Las Cruces, NM 88012 | 2014-01-28 |
| 1144642133 | Minerva L Saavedra | Case Manager/Care Coordinator | 3823 Fossil Court, Las Cruces, NM 88012 | 2014-01-10 |
| 1780931089 | Elida Hernandez | Case Manager/Care Coordinator | 5572 La Reina, Las Cruces, NM 88012 | 2012-08-07 |
| 1841546231 | Mary Jane Duran | Case Manager/Care Coordinator | 2882-3 Glass Rd, Las Cruces, NM 88012 | 2012-08-03 |
| Find all providers in zip 88012 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750947420 | Great Livin II LLC | Intermediate Care Facility, Mentally Retarded | 4028 Mescalero Rd Ne, Albuquerque, NM 87110-1754 | 2019-05-17 |
| 1548474141 | New Horizons Casa Linda | Intermediate Care Facility, Mentally Retarded | 810 Avenue E, Carrizozo, NM 88301-0187 | 2007-05-10 |
| 1386773398 | Carc, Inc. | Intermediate Care Facility, Mentally Retarded | 902 W Cherry Ln, Carlsbad, NM 88220-8804 | 2007-03-05 |
| 1851428577 | Santa Maria El Mirador | Intermediate Care Facility, Mentally Retarded | 2041 S Pacheco St, Suite 100, Santa Fe, NM 87505-5473 | 2007-02-28 |
| 1992830012 | Arca - Corrales | Intermediate Care Facility, Mentally Retarded | 181 East La Entrada, Corrales, NM 87048 | 2007-02-22 |
| 1295870020 | Arca - Copper Home | Intermediate Care Facility, Mentally Retarded | 9101 Copper Ave Ne, Albuquerque, NM 87123-1007 | 2007-02-20 |
| 1720123565 | Arca - Gun Club | Intermediate Care Facility, Mentally Retarded | 2404 Gun Club Rd Sw, Albuquerque, NM 87105-6326 | 2007-02-20 |
| 1043355878 | Arca - Gibson Home | Intermediate Care Facility, Mentally Retarded | 5605 Gibson Blvd Se, Albuquerque, NM 87108-4831 | 2007-02-20 |
| 1336284165 | Arca - Trumbull | Intermediate Care Facility, Mentally Retarded | 7100 Trumbull Ave Se, Albuquerque, NM 87108-3984 | 2007-02-20 |
| 1134264971 | Arca - Louisiana | Intermediate Care Facility, Mentally Retarded | 615 Louisiana Blvd Se, Albuquerque, NM 87108-3844 | 2007-02-20 |
| Find all providers with the same taxonomy | ||||
| City | LAS CRUCES |
| Zip Code | 88012 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.