Provider Demographics
NPI:1306244041
Name:EDEN HEALTHCARE LLC
Entity type:Organization
Organization Name:EDEN HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UCHECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:346-402-7272
Mailing Address - Street 1:82036 WILLOW PLACE SOUTH #220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5655
Mailing Address - Country:US
Mailing Address - Phone:713-414-5438
Mailing Address - Fax:713-414-5439
Practice Address - Street 1:8203 WILLOW PLACE DR S # 220
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5655
Practice Address - Country:US
Practice Address - Phone:713-414-5438
Practice Address - Fax:713-414-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677975251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health