Provider Demographics
NPI:1629965520
Name:EVERHAVEN LLC
Entity type:Organization
Organization Name:EVERHAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIANGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-951-0328
Mailing Address - Street 1:150 HUSSON AVE APT 39
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 HUSSON AVE APT 39
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3262
Practice Address - Country:US
Practice Address - Phone:207-951-0328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care