Provider Demographics
NPI:1790523926
Name:EMINENCE CARE LLC
Entity type:Organization
Organization Name:EMINENCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:OLUWASEUN
Authorized Official - Last Name:JEGEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-630-1138
Mailing Address - Street 1:98 MAYFIELD DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3033
Mailing Address - Country:US
Mailing Address - Phone:216-630-1138
Mailing Address - Fax:
Practice Address - Street 1:98 MAYFIELD DR STE 202
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-3033
Practice Address - Country:US
Practice Address - Phone:216-630-1138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-20
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency