# EAGLE ACQUISITION XII LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Concordia Transitional Care and Rehabilitation - Nansemond Pointe
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811412570
- **Authorized official:** BENT PHILIPSON (MANAGING MEMBER)
- **Authorized official phone:** (516) 869-3700

## Contact information

- **Practice address:** 200 W CONSTANCE RD, SUFFOLK, VA 23434-4413
- **Practice address phone:** (757) 539-8744
- **Practice address fax:** (747) 539-6128
- **Mailing address:** 200 W CONSTANCE RD, SUFFOLK, VA 23434-4413
- **Mailing address phone:** (757) 539-8744
- **Mailing address fax:** (747) 539-6128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/03/2017
- **Last updated:** 07/21/2022