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General NPI Number Information
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NPI Number | 1265717805
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Entity Type | Organization
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Legal Business Name | EL EDEN, CORP.
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 10460 N.W. 129 STREET
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018
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Country | US
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Telephone | 305-819-5933
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Fax | 786-534-2187
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Provider Business Mailing Address
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Address Line | 10460 N.W. 129 STREET
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018
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Country | US
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Telephone | 305-819-5933
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Fax | 786-534-2187
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Authorized Official
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Title or Position | OWNER
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Name | MARISOL FERRER
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Credential |
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Telephone | 786-488-2651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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