Eden Behavioral Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EDEN BEHAVIORAL SERVICES, LLC

Practice address

414 W Village Dr
Greenville, NC 27834-3727

Phone

(919) 824-7326

NPI assigned

Nov 11, 2009

Last updated

Nov 11, 2009By 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

Mr. Dwayne D Gray

Title

Owner/Ceo

Phone

(919) 824-7326

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257897600000",
    "number": "1467789503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W VILLAGE DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343727",
            "telephone_number": "919-824-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W VILLAGE DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343727",
            "telephone_number": "919-824-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN BEHAVIORAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "919-824-7326",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ecu Physicians Diagnostic Pathology Services
• Ecu Speech Language & Hearing Clinic
• Edc Drug Stores Inc (Rite Aid Pharmacy 11418)
• Edc Drug Stores Inc (Rite Aid Pharmacy 11416)
• Edc Drug Stores Inc (Rite Aid Pharmacy 11419)
• Melydia J Edge, CRNA
• Tyler Nigele Edgerton
• Hunter Edmonds
• Brittany Edmondson, LCMHCA
• Natasha L. Edmondson, PHARM.D.

• Community/Behavioral Health Agency in Greenville, NC
• Providers in Greenville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.