Organization
AMERICAN EAGLE PLEASANT PRAIRIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY WAKE (ASSISTANT SECRETARY)
(734) 418-9027
Entity
Organization
Contact information
Practice address
7377 88TH AVE, KENOSHA, WI 53142-8206
(734) 418-9027
Mailing address
3819 HAWK CREST RD, ANN ARBOR, MI 48103-4246
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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