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Organization

EAGLES WILL NC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL FISCHMAN (CEO)
(917) 648-4292
Entity
Organization

Contact information

Practice address
1515 MOCKINGBIRD LN STE 420, CHARLOTTE, NC 28209-3236
(917) 648-4292
Mailing address
1413 38TH ST, BROOKLYN, NY 11218-3613
(917) 648-4292

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
01/15/2024
Last updated
11/14/2024
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