American Eagle Eau Gallie LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AMERICAN EAGLE EAU GALLIE LLC

Practice address

2680 Croton Rd
Melbourne, FL 32935-3576

Phone

(734) 418-9027

NPI assigned

Jul 30, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cory Wake

Title

Associate

Phone

(734) 418-9027

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1144708421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 HAWK CREST RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034246",
            "telephone_number": "734-418-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 CROTON RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353576",
            "telephone_number": "734-418-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EAGLE EAU GALLIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "WAKE",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "734-418-9027"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.