Provider Demographics
NPI:1356701171
Name:EDEN GROUP COUNSELING
Entity type:Organization
Organization Name:EDEN GROUP COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERILL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-788-9665
Mailing Address - Street 1:324 LANTANA AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1510
Mailing Address - Country:US
Mailing Address - Phone:201-569-2424
Mailing Address - Fax:201-569-2433
Practice Address - Street 1:324 LANTANA AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1510
Practice Address - Country:US
Practice Address - Phone:201-569-2424
Practice Address - Fax:201-569-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child