NPIMap

Organization Active NPI

Eagle Home 5

  • Adult Care Home Facility
  • Raleigh, NC
National Provider Identifier
1639299431
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
MHL092620 Issued in NC
Legal business name
EAGLE HOME 5
Practice address
8020 Caliber Woods Dr
Raleigh, NC 27616-8649
Phone
(919) 217-7813
Fax
(919) 217-7813
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rosemary Nwankwo
Title
Administrator
Phone
(919) 217-7813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X MHL092620 NC Primary

Addresses

Primary practice location

8020 Caliber Woods Dr
Raleigh, NC 27616-8649

Mailing address

8020 Caliber Woods Dr
Raleigh, NC 27616-8649
Phone (919) 217-7813

Other identifiers 1

IdentifierTypeStateIssuer
7805144MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Eagle Home 52 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639299431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 CALIBER WOODS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168649",
            "telephone_number": "919-217-7813",
            "fax_number": "919-217-7813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 CALIBER WOODS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168649",
            "telephone_number": "919-217-7813",
            "fax_number": "919-217-7813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HOME 5",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-217-7813"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL092620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805144",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.