Provider Demographics
NPI:1558177006
Name:EDEN COMMUNITY HEALTH OF MISSOURI-KANSAS CITY LLC
Entity type:Organization
Organization Name:EDEN COMMUNITY HEALTH OF MISSOURI-KANSAS CITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MATEO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-942-2800
Mailing Address - Street 1:800 E 101ST TER STE 350
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-5310
Mailing Address - Country:US
Mailing Address - Phone:913-942-2800
Mailing Address - Fax:913-942-2801
Practice Address - Street 1:800 E 101ST TER STE 350
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-5310
Practice Address - Country:US
Practice Address - Phone:913-942-2800
Practice Address - Fax:913-942-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care