Provider Demographics
NPI:1073808762
Name:EDDLEMAN, LLC
Entity Type:Organization
Organization Name:EDDLEMAN, LLC
Other - Org Name:HOME INSTEAD SENIOR CARE #757
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:EDDLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-454-1211
Mailing Address - Street 1:215 WINCHESTER DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8818
Mailing Address - Country:US
Mailing Address - Phone:903-617-6892
Mailing Address - Fax:
Practice Address - Street 1:215 WINCHESTER DR
Practice Address - Street 2:SUITE 106
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8818
Practice Address - Country:US
Practice Address - Phone:903-617-6892
Practice Address - Fax:903-617-6893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care