Eden House Home Care, LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

EDEN HOUSE HOME CARE, LLC

Practice address

120 W Tyler Ave Ste 200
West Memphis, AR 72301-4221

Phone

(870) 394-4818

Fax

(870) 394-4806

NPI assigned

Mar 26, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Ricky Griffin, N.H.A.

Title

Administrator/Ceo

Phone

(870) 394-4818

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1912468711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W TYLER AVE STE 200",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014221",
            "telephone_number": "870-394-4818",
            "fax_number": "870-394-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W TYLER AVE STE 200",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014221",
            "telephone_number": "870-394-4818",
            "fax_number": "870-394-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN HOUSE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "870-394-4818",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N.H.A."
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224879732",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edenhouse@electcompany.com",
            "affiliation": "N",
            "endpointDescription": "corporate email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "120 W Tyler Ave Ste 200",
            "city": "West Memphis",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723014221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Kristen Eldridge
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• Personal Care Attendant in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Personal Care Attendant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.