Provider Demographics
NPI:1033632161
Name:EDEN LIVING PLLC
Entity Type:Organization
Organization Name:EDEN LIVING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCMHC
Authorized Official - Phone:603-831-1686
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:NH
Mailing Address - Zip Code:03449-0225
Mailing Address - Country:US
Mailing Address - Phone:603-831-1686
Mailing Address - Fax:603-525-3616
Practice Address - Street 1:58 BONDS CORNER RD
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:NH
Practice Address - Zip Code:03449-5807
Practice Address - Country:US
Practice Address - Phone:603-831-1686
Practice Address - Fax:603-525-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3111970Medicaid
NH3101892Medicaid