# EAGLESNEST GROUP CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609045350
- **Authorized official:** MELANIE VIRGINIA KENNEDY (ADMINISTRATOT)
- **Authorized official phone:** (303) 838-2468

## Contact information

- **Practice address:** 1149 DICK MOUNTAIN DR, BAILEY, CO 80421-2097
- **Practice address phone:** (303) 838-2468
- **Practice address fax:** (303) 838-2478
- **Mailing address:** 1149 DICK MOUNTAIN DR, BAILEY, CO 80421-2097
- **Mailing address phone:** (303) 838-2468
- **Mailing address fax:** (303) 838-2478

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 1544800 | CO | Yes |

## Other

- **Enumeration date:** 02/27/2008
- **Last updated:** 02/27/2008