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General NPI Number Information
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NPI Number | 1811614035
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Entity Type | Organization
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Legal Business Name | EDEN HOMECARE CENTER,LLC
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 7700 LITTLE RIVER TPKE STE 403
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City | ANNANDALE
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State | VA
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Zip | 22003-2406
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Country | US
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Telephone | 571-622-1166
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Fax | 571-441-6226
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Provider Business Mailing Address
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Address Line | 7700 LITTLE RIVER TPKE STE 403
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City | ANNANDALE
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State | VA
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Zip | 22003-2406
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Country | US
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Telephone | 571-622-1166
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Fax | 571-441-6226
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Authorized Official
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Title or Position | CEO
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Name | MR. STEVE HUU DANG
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Credential | HOME HEALTH CARE
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Telephone | 571-354-1015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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