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Organization

MOUNT EAGLE HEALTH CARE GREENSBORO, LLC

Active
Other names
MOUNT EAGLE HEALTH CARE
Organization subpart
No

Provider details

NPI number
Authorized official
DOROTHY EDWARD SHALLUA RN (DIRECTOR)
(336) 283-5191
Entity
Organization

Contact information

Practice address
1 CENTERVIEW DR STE 203, GREENSBORO, NC 27407-3712
(336) 283-5191
(336) 499-6532
Mailing address
1 CENTERVIEW DR STE 203, GREENSBORO, NC 27407-3712
(336) 283-5191
(336) 499-6532

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC4420
NC
251F00000X
Home Infusion Agency
HC4420
NC
251J00000X
Nursing Care Agency
HC4420
NC
251S00000X
Community/Behavioral Health Agency
Primary
HC4420
NC
253Z00000X
In Home Supportive Care Agency
HC4420
NC

Other

Enumeration date
09/02/2015
Last updated
09/02/2015
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