Organization
EEAGLES NEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROOSEVELT OWENS (OWNER)
(757) 694-1669
Entity
Organization
Contact information
Practice address
1601 TEWKSBURY CT, VIRGINIA BEACH, VA 23456-4864
(757) 351-6255
Mailing address
1020 STEELEMAN LN, CHESAPEAKE, VA 23320-5053
(757) 694-1669
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
03/28/2024
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