Provider Demographics
NPI:1407359086
Name:EDEN'S HOME HEALTH CARE
Entity Type:Organization
Organization Name:EDEN'S HOME HEALTH CARE
Other - Org Name:EDEN'S CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-439-1821
Mailing Address - Street 1:1400 VETERANS MEMORIAL HWY SE # 134-272
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2945
Mailing Address - Country:US
Mailing Address - Phone:904-469-8813
Mailing Address - Fax:
Practice Address - Street 1:804 WALTON WAY S.E.
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-2945
Practice Address - Country:US
Practice Address - Phone:678-439-1821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care