Provider Demographics
NPI:1811614035
Name:EDEN HOMECARE CENTER,LLC
Entity type:Organization
Organization Name:EDEN HOMECARE CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:HUU
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:HOME HEALTH CARE
Authorized Official - Phone:571-354-1015
Mailing Address - Street 1:7700 LITTLE RIVER TPKE STE 403
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2406
Mailing Address - Country:US
Mailing Address - Phone:571-622-1166
Mailing Address - Fax:571-441-6226
Practice Address - Street 1:7700 LITTLE RIVER TPKE STE 403
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2406
Practice Address - Country:US
Practice Address - Phone:571-622-1166
Practice Address - Fax:571-441-6226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health