Provider Demographics
NPI:1568047165
Name:AMY'S EDEN ASSISTED HOMES, LLC
Entity Type:Organization
Organization Name:AMY'S EDEN ASSISTED HOMES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:RFA
Authorized Official - Phone:800-856-6039
Mailing Address - Street 1:1204 CAMBALLERIA DR
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-8655
Mailing Address - Country:US
Mailing Address - Phone:801-856-6039
Mailing Address - Fax:
Practice Address - Street 1:800 S MEADOWS PKWY STE 500
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-2976
Practice Address - Country:US
Practice Address - Phone:775-499-5461
Practice Address - Fax:775-499-5460
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMY'S EDEN SENIOR CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty