Organization
EAGLE HOME #9
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY NWANKWO (ADMINISTRATOR)
(919) 872-7686
Entity
Organization
Contact information
Practice address
627 DONALD ROSS DR, RALEIGH, NC 27610-2817
(919) 803-3130
Mailing address
4428 LOUISBURG RD, SUITE 109, RALEIGH, NC 27616-4302
(919) 803-3130
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
562412291
NC
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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