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NPI Code Detail

MEDICARE: EDEN GARDENS, LLC

MEDICARE: EDEN GARDENS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityAL8209FL
23104A0625XAssisted Living Facility (Mental Illness)AL8209FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003018482
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDEN GARDENS, LLC
Provider Business Mailing Address
First Line : 140 W 28TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33010-1606
Country : US
Telephone Number : 305-863-0002
Fax Number :
Provider Business Practice Location Address
First Line : 12221 W DIXIE HWY
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33161-5427
Country : US
Telephone Number : 305-893-2634
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : CLAUDIA PACE
Credential :
Telephone Number : 305-863-0002
Provider Enumeration Date : 06/05/2007
Last Update Date : 09/11/2025

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Directions to “EDEN GARDENS, LLC ” Practice Location

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