Organization Active NPI

Eden Center of Life Inc

  • Professional Counselor
  • Warren, MI
National Provider Identifier
1134799752
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
EDEN CENTER OF LIFE INC
Practice address
25551 Pine View Ave
Warren, MI 48091-3888
Phone
(313) 673-0807
NPI assigned
Jun 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Ann McPherson, LPCNPI 1356942932
Title
Professional Counselor
Phone
(313) 673-0807

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

25551 Pine View Ave
Warren, MI 48091-3888

Mailing address

25551 Pine View Ave
Warren, MI 48091-3888
Phone (313) 673-0807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250916003638 MI Part B Supplier - Clinic/Group Practice 0941704621 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Locations

17340 W 12 Mile Rd
Ste 100
Southfield, MI 48076
Phone (313) 673-0807

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1134799752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25551 PINE VIEW AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480913888",
            "telephone_number": "313-673-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25551 PINE VIEW AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480913888",
            "telephone_number": "313-673-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN CENTER OF LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-27",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "MCPHERSON",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "313-673-0807",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.