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General NPI Number Information
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NPI Number | 1497949564
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Entity Type | Organization
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Legal Business Name | EDEN MANAGEMENT LTD
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 940 W GORDON TERRACE
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City | CHICAGO
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State | IL
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Zip | 60613
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Country | US
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Telephone | 773-472-1020
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Fax | 773-472-2985
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Provider Business Mailing Address
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Address Line | 940 W GORDON TERRACE
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City | CHICAGO
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State | IL
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Zip | 60613
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Country | US
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Telephone | 773-472-1020
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Fax | 773-472-2985
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL JON HAMBLET
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Credential |
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Telephone | 773-572-6486
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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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