American Eagle Leesburg Al LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AMERICAN EAGLE LEESBURG AL LLC

Practice address

700 S Lake St
Leesburg, FL 34748-7321

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": "1861970147",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S LAKE ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487321",
            "telephone_number": "734-418-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EAGLE LEESBURG AL 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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• All providers in Leesburg, FL
• 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.