Eden's Garden Assisted Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EDEN'S GARDEN ASSISTED LIVING FACILITY LLC

Practice address

1598 Giles St NW
PRVT
Palm Bay, FL 32907-7077

Phone

(321) 499-3522

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

Nichole Gordon

Title

Administrator

Phone

(321) 499-3522

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1912455825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 GILES ST NW",
            "address_2": "PRVT",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329077077",
            "telephone_number": "321-499-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1598 GILES ST NW",
            "address_2": "PRVT",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329077077",
            "telephone_number": "321-499-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN'S GARDEN ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-499-3522"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley F Dziedzic, D.O.
• Kailey Earle
• Lucinda Kathryn Earls, CNA
• Easter Seals Florida, Inc.
• Echelle Inc (Echelle Day Spa)
• Edens Garden Alf LLC
• Lorraine Edey, LCSW
• Kayla Edwards
• Steven D Eggen, M.D.
• Erica Eisel, RMHCI

• Assisted Living Facility in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.