Provider Demographics
NPI:1356177687
Name:EDEN HOUSING
Entity type:Organization
Organization Name:EDEN HOUSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, RESIDENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-269-9192
Mailing Address - Street 1:22645 GRAND ST # A
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-5031
Mailing Address - Country:US
Mailing Address - Phone:650-269-9194
Mailing Address - Fax:510-247-8110
Practice Address - Street 1:22645 GRAND ST # A
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-5031
Practice Address - Country:US
Practice Address - Phone:650-269-9194
Practice Address - Fax:510-247-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management