Eden Homes, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2809378 Issued in MN

Legal business name

EDEN HOMES, INC.

Practice address

3714 Bryant Ave N
Minneapolis, MN 55412-2157

Phone

(612) 724-1593

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Fidela Villanueva

Title

President

Phone

(612) 724-1593

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1588058911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122157",
            "telephone_number": "612-724-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 BRYANT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122157",
            "telephone_number": "612-724-1593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "FIDELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-724-1593",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "2809378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Wallis Eddy, D.O.
• Jancy Ann Eddy, WHNP-BC
• Kaitlyn Marie Eddy, MS, GC
• Kathryn Ede-Imafidon, FNP-BC
• Megan Edelman, MS, RD, LD
• Faith Farhan Eden
• Kimberley Marie Edens, LADC
• Lucy Edens, DPT
• Katherine J Eder
• Meron A Edessa

• Assisted Living Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.