Healthcare Provider Details

I. General information

NPI: 1649109042
Provider Name (Legal Business Name): EDEN HEIGHTS OF EDEN OPERATING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4071 HARDT RD
EDEN NY
14057-9650
US

IV. Provider business mailing address

4071 HARDT RD
EDEN NY
14057-9650
US

V. Phone/Fax

Practice location:
  • Phone: 716-992-4466
  • Fax:
Mailing address:
  • Phone: 716-992-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: ADRIENNE FRANCE
Title or Position: ACCOUNTING & HR SPECIALIST
Credential:
Phone: 716-992-4466