Eaglesnest Group Center

Organization Active NPI Physical Disabilities Residential Treatment Facility · Bailey, CO

NPI 1609045350 · NPPES record last updated Feb 27, 2008

Key facts

NPI
1609045350
Entity type
Organization (NPI type 2)
Primary specialty
Physical Disabilities Residential Treatment Facility 320700000X
License
1544800 (CO)
Legal business name
EAGLESNEST GROUP CENTER
Practice address
1149 Dick Mountain Dr
Bailey, CO 80421-2097
Phone
(303) 838-2468
Fax
(303) 838-2478
NPI assigned
Feb 27, 2008
Organization subpart
No

Authorized official

Name
Melanie Virginia Kennedy NPI 1205361755
Title
Administratot
Phone
(303) 838-2468

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Eagle'S Nest Group Center (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 1544800 CO Yes

Addresses

Primary practice location

1149 Dick Mountain Dr
Bailey, CO 80421-2097

Mailing address

1149 Dick Mountain Dr
Bailey, CO 80421-2097
Phone (303) 838-2468

Other providers in Bailey, CO

All providers in Bailey, CO · Physical Disabilities Residential Treatment Facility in Colorado

Sources for this page

Verify at the official NPI Registry.