American Eagle Owatonna Al LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AMERICAN EAGLE OWATONNA AL LLC

Doing business as

Timberdale Trace

Practice address

3819 Hawk Crest Rd
Ann Arbor, MI 48103-4246

Phone

(734) 418-9027

NPI assigned

Oct 1, 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

Other names 1

• Timberdale Trace Doing business as

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1619452182",
    "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": "3819 HAWK CREST RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034246",
            "telephone_number": "734-418-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EAGLE OWATONNA AL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "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": [
        {
            "organization_name": "Timberdale Trace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.