Eden Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

980001365 Issued in CA

Legal business name

EDEN HOME HEALTH CARE, INC.

Practice address

159 E Live Oak Ave Ste 205
Arcadia, CA 91006-5252

Phone

(626) 573-1001

Fax

(626) 573-1005

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Ivy Villanueva Lagon-Fernandez, RN

Title

Ceo

Phone

(626) 573-1001

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 058105

Legal name

EDEN HOME HEALTH CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 5, 2002

Last certification

Feb 11, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jun 14, 2001 in CA

Enrollment address

159 E Live Oak Ave
Ste 205
Arcadia, CA 91006-5252

Listed as

Eden Home Health Care IncCCN 058105

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Mar 5, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Roy Harper Jackson, M.D.

  • Internal Medicine Physician
  • Pasadena, CA
  • NPI 1669424982

  Home health agency

  Care Compare affiliation
• Dean Lamar Townsend, P.A.

  • Physician Assistant
  • Beaumont, CA
  • NPI 1831181551

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1295844256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 E LIVE OAK AVE STE 205",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065252",
            "telephone_number": "626-573-1001",
            "fax_number": "626-573-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E LIVE OAK AVE STE 205",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910065252",
            "telephone_number": "626-573-1001",
            "fax_number": "626-573-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "LAGON-FERNANDEZ",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "VILLANUEVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-573-1001",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "980001365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08105F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Valley Community Health Center, Inc.
• Juan Carlos Echeverria, M.D.
• Maria Guadalupe Echeverria
• Eddie So, D.D.S., a Dental Corporation
• Maelisa Aileen Eddy, LMFT
• Eden Hospice Inc
• Edgar Olivas M.D., Inc
• Edream Dental Group
• Abigail Elizabeth Edwards, M.A.
• Dominique Edwards

• Home Health Agency in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.