Organization
ENTC LLC
Active
Organization
ENTC LLC
Active
Other names
Eagles Nest
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA FOLTZ (PRESIDENT)
(928) 566-2488
Entity
Organization
Contact information
Practice address
1813 AMBAS DR, LAKE HAVASU CITY, AZ 86403-7445
(928) 566-2488
Mailing address
55 LAKE HAVASU AVENUE, SUITE F, BOX 856, LAKE HAVASU CITY, AZ 86403
(928) 566-2488
(928) 955-8440
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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