Eden Manor LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

LC9786208 Issued in MO

Legal business name

EDEN MANOR LLC

Practice address

1361 Arlington Ave
Saint Louis, MO 63112-4131

Phone

(314) 833-4313

Fax

(314) 833-4313

NPI assigned

Apr 17, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Michelle Nicole Ross

Title

Executive Director

Phone

(314) 814-2594

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460851200000",
    "number": "1205280120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 ARLINGTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124131",
            "telephone_number": "314-833-4313",
            "fax_number": "314-833-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 ARLINGTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124131",
            "telephone_number": "314-833-4313",
            "fax_number": "314-833-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-17",
        "last_updated": "2016-04-17",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-814-2594",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "LC9786208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark C Eddy, MD
• Adam J Edelman, M.D.
• Tracy Lynn Edelmann, D.C.
• Brian Todd Edelson, M.D., PH.D.
• Sean Lewis Edelstein, MD
• Eden Pediatrics LLC
• Edens Sacred Hand Homecare, LLC
• Stacey Lynn Ederer
• Julia D Edgar, MA
• Randall C Edgell, MD

• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2016; 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.