# EAGLE ACQUISITION III LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Concordia Healthcare Center - Heritage Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992229603
- **Authorized official:** BENT PHILIPSON (MANAGING MEMBER)
- **Authorized official phone:** (516) 869-3700

## Contact information

- **Practice address:** 401 INDIANA AVE, MAYFIELD, KY 42066-1766
- **Practice address phone:** (270) 247-0200
- **Practice address fax:** (270) 247-8913
- **Mailing address:** 401 INDIANA AVE, MAYFIELD, KY 42066-1766
- **Mailing address phone:** (270) 247-0200
- **Mailing address fax:** (270) 247-8913

## Taxonomy

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

## Other

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