Provider Demographics
NPI:1689143331
Name:EDEN HOME HEALTH, LLC.
Entity Type:Organization
Organization Name:EDEN HOME HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HOMERO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:830-968-1410
Mailing Address - Street 1:2988 TEHUACAN DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5729
Mailing Address - Country:US
Mailing Address - Phone:830-968-1410
Mailing Address - Fax:
Practice Address - Street 1:2435 N VETERANS BLVD STE A
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6483
Practice Address - Country:US
Practice Address - Phone:830-765-6516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty