Eden Homecare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EDEN HOMECARE LLC

Practice address

4468 Edgemont Dr SW
Wyoming, MI 49519-4216

Phone

(616) 466-3154

NPI assigned

Jun 13, 2021

Last updated

Jun 15, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kofi Kakra Effraim

Title

Ceo

Phone

(616) 466-3154

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1043888498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4468 EDGEMONT DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194216",
            "telephone_number": "616-466-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4468 EDGEMONT DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194216",
            "telephone_number": "616-466-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-13",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "EFFRAIM",
        "authorized_official_first_name": "KOFI",
        "authorized_official_middle_name": "KAKRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-466-3154"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.