EDEN HOUSE HOME CARE, LLC (NPI# 1912468711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912468711 |
| Entity Type | Organization |
| Organization Name | EDEN HOUSE HOME CARE, LLC |
| Practice Address |
120 W Tyler Ave Ste 200 West Memphis AR 72301-4221 |
| Practice Telephone | 8703944818 |
| Practice Fax Number | 8703944806 |
| Mailing Telephone | 8703944818 |
| Mailing Fax Number | 8703944806 |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-04-10 |
| Authorized Official Name | MR. RICKY GRIFFIN (ADMINISTRATOR/CEO) |
| Authorized Official Telephone | 8703944818 |
| Authorized Official Credential | N.H.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 224879732 | 05 |
| Street Address |
120 W TYLER AVE STE 200 |
| City | WEST MEMPHIS |
| State | AR |
| Zip Code | 72301-4221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755497 | Shannon Mcelroy | Pharmacist | 300 I-40 Service Rd, West Memphis, AR 72301 | 2020-06-23 |
| 1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
| 1174161475 | Mary Williams | Pharmacist | 300 I-40 Service Road, West Memphis, AR 72301 | 2019-12-17 |
| 1336787035 | Yolanda Monique Fulton | Assisted Living Facility | 711 Purduve Ave, West Memphis, AR 72301 | 2019-12-13 |
| 1255813317 | Urgent Care Travel, Inc | Clinic/Center | 3400 Service Loop 2, West Memphis, AR 72301 | 2018-09-05 |
| 1841770302 | Cuffie Healthcare LLC | Home Health | 403 Ingram Blvd, West Memphis, AR 72301 | 2018-08-15 |
| 1467940312 | Mark Aaron Whitlock | Dentist | 110 Dover Rd, West Memphis, AR 72301 | 2018-04-26 |
| 1043715329 | Crossroads Treatment Center of West Memphis, PC | Clinic/Center | 103 S Avalon St, West Memphis, AR 72301 | 2018-03-28 |
| 1114445202 | Deborah Thompson Ferguson | Dentist | 200 S Rhodes St Ste B, West Memphis, AR 72301 | 2017-09-08 |
| 1154745487 | Erin Camille Greer | Specialist/Technologist | 610 N. Missouri Street, Suite 1, West Memphis, AR 72301 | 2014-02-06 |
| Find all providers in zip 72301 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952855892 | Melody Houston | Technician | 225 N 5th St, West Memphis, AR 72301-3212 | 2016-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922540 | Home Health Care Agency of Arkansas, LLC | Technician | 1200 John Barrow Rd Ste 111, Little Rock, AR 72205-6528 | 2020-11-03 |
| 1770110488 | Roger Barnes | Technician | 4836 Park Ave Ste B, Hot Springs, AR 71901-9477 | 2020-03-24 |
| 1184259210 | Little Joe Scott | Technician | 2702 Amhurst, Magnolia, AR 71753-4216 | 2020-03-09 |
| 1598303968 | Brandon Lee Hutchison | Technician | 152 Birchwood Cir, Cabot, AR 72023-2585 | 2019-12-17 |
| 1417599788 | E & D Private Care Agency | Technician | 3051 Waverly Rd, Proctor, AR 72376 | 2019-10-08 |
| 1275184749 | Home Care Network LLC | Technician | 2607 W 28th Ave, Pine Bluff, AR 71603-4916 | 2019-09-25 |
| 1720639347 | Always Promoting Independence Homecare, LLC | Technician | 1004 Brantley Ave, North Little Rock, AR 72117-2146 | 2019-09-25 |
| 1235784893 | Elite Care, LLC | Technician | 130 West 2nd St., Malvern, AR 72104-3708 | 2019-08-09 |
| 1245791094 | Kim Callicutt | Technician | 110 Block St, Marion, AR 72364-1956 | 2019-03-26 |
| 1760992911 | Lorraine Irene Devries | Technician | 1316 Industrial Acess Drive, Trumann, AR 72472 | 2017-10-02 |
| Find all providers with the same taxonomy | ||||
| City | WEST MEMPHIS |
| Zip Code | 72301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.