| Organization Name: | EDEN ADULT MEDICAL DAYCARE CENTER, INC. |
| NPI Number: | 1295071074 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY SHINSOON LEE (OWNER) |
| Mailing Address: | 10947 Golden West Dr Ste 200 Hunt Valley |
| State: | MD US |
| Postal Code: | 210311341 |
| Phone Number: | 4103291444 |
| Fax Number: | 4103291533 |
| NPI Enumeration Date: | 12/22/2012 |
| NPI Last Update Date: | 12/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 03-025-A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |