Organization
EAGLE HOME 5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY NWANKWO (ADMINISTRATOR)
(919) 217-7813
Entity
Organization
Contact information
Practice address
8020 CALIBER WOODS DR, RALEIGH, NC 27616-8649
(919) 217-7813
(919) 217-7813
Mailing address
8020 CALIBER WOODS DR, RALEIGH, NC 27616-8649
(919) 217-7813
(919) 217-7813
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL092620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805144
—
NC
Enumeration date
03/29/2007
Last updated
08/22/2020
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