Organization
EVERLASTING HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK PETERSON JR. (CEO)
(317) 765-8151
Entity
Organization
Contact information
Practice address
4615 E 10TH ST STE 2, INDIANAPOLIS, IN 46201-2823
(317) 765-8151
Mailing address
4615 E 10TH ST STE 2, INDIANAPOLIS, IN 46201-2823
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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