Provider Demographics
NPI:1982439477
Name:EDEN HOUSE CARE CENTER LLC
Entity type:Organization
Organization Name:EDEN HOUSE CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-259-5329
Mailing Address - Street 1:3840 S DAIRY ASHFORD RD STE 2005
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5609
Mailing Address - Country:US
Mailing Address - Phone:281-654-8720
Mailing Address - Fax:
Practice Address - Street 1:13106 ROYAL BELL CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-2524
Practice Address - Country:US
Practice Address - Phone:713-259-5329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based