Provider Demographics
NPI:1508403833
Name:EDEN PATHWAYS
Entity Type:Organization
Organization Name:EDEN PATHWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROXANEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-884-6840
Mailing Address - Street 1:700 TWELVE OAKS CENTER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4415
Mailing Address - Country:US
Mailing Address - Phone:267-884-6840
Mailing Address - Fax:952-446-7283
Practice Address - Street 1:700 TWELVE OAKS CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4415
Practice Address - Country:US
Practice Address - Phone:267-884-6840
Practice Address - Fax:952-446-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health