| Organization Name: | VAN EEDEN, LLC |
| NPI Number: | 1144471327 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHNETTE H VAN EEDEN (PRESIDENT) |
| Mailing Address: | 451 Westpark Way Ste 1 Euless |
| State: | TX US |
| Postal Code: | 760403994 |
| Phone Number: | 8175716425 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2008 |
| NPI Last Update Date: | 06/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |