Organization
EDEN HOUSE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICKY GRIFFIN N.H.A. (ADMINISTRATOR/CEO)
(870) 394-4818
Entity
Organization
Contact information
Practice address
120 W TYLER AVE STE 200, WEST MEMPHIS, AR 72301-4221
(870) 394-4818
(870) 394-4806
Mailing address
120 W TYLER AVE STE 200, WEST MEMPHIS, AR 72301-4221
(870) 394-4818
(870) 394-4806
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224879732
—
AR
Enumeration date
03/26/2019
Last updated
04/10/2019
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