Provider Demographics
NPI:1366234809
Name:EDEN WELLNESS GROUP, LLC.
Entity type:Organization
Organization Name:EDEN WELLNESS GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-773-7365
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:LYFORD
Mailing Address - State:TX
Mailing Address - Zip Code:78569-0858
Mailing Address - Country:US
Mailing Address - Phone:956-773-7365
Mailing Address - Fax:
Practice Address - Street 1:11040 FM 1761
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4751
Practice Address - Country:US
Practice Address - Phone:956-773-7365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDEN WELLNESS GROUP, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251F00000XAgenciesHome Infusion
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy