Organization
EAGLE VILLAGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHEY PRUDHOMME (CEO)
(231) 832-7259
Entity
Organization
Contact information
Practice address
4507 170TH AVE, HERSEY, MI 49639-8785
(231) 832-2234
Mailing address
4507 170TH AVE, HERSEY, MI 49639-8785
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/17/2015
Last updated
11/15/2022
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