# EAGLE HOME \#9

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

## Provider details

- **NPI number:** 1710252788
- **Authorized official:** ROSEMARY NWANKWO (ADMINISTRATOR)
- **Authorized official phone:** (919) 872-7686

## Contact information

- **Practice address:** 627 DONALD ROSS DR, RALEIGH, NC 27610-2817
- **Practice address phone:** (919) 803-3130
- **Mailing address:** 4428 LOUISBURG RD, SUITE 109, RALEIGH, NC 27616-4302
- **Mailing address phone:** (919) 803-3130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 562412291 | NC | Yes |

## Other

- **Enumeration date:** 03/09/2012
- **Last updated:** 03/09/2012