Provider Demographics
NPI:1760665293
Name:EDON HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:EDON HEALTHCARE SERVICES, INC.
Other - Org Name:EDON RESIDENTAIL AND RESCARE SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FOUNDER/CEO&ASSISTED LIVING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-740-9891
Mailing Address - Street 1:436 GIRARD ST
Mailing Address - Street 2:104
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3303
Mailing Address - Country:US
Mailing Address - Phone:301-740-9891
Mailing Address - Fax:301-740-9892
Practice Address - Street 1:436 GIRARD ST
Practice Address - Street 2:104
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-3303
Practice Address - Country:US
Practice Address - Phone:301-740-9891
Practice Address - Fax:301-740-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances