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Organization
EAGLE EYE GROUP HOME, INC.
Active
Organization
EAGLE EYE GROUP HOME, INC.
Active
Other names
EAGLE EYE GROUP HOME, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE ANNMARIE ANNIKEY MEDICAID PROVIDER (CEO)
(321) 978-6509
Entity
Organization
Contact information
Practice address
415 EAGLE EYE GROUP HOME, INC, KISSIMMEE, FL 34759
(863) 547-4886
(863) 547-4993
Mailing address
415 EAGLE DR, KISSIMMEE, FL 34759-4432
(863) 547-4886
(863) 547-4993
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
385H00000X
Respite Care
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692345396
—
FL
Enumeration date
02/18/2022
Last updated
02/18/2022
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