NPIMap

Organization Active NPI

Eagle Home 2

  • Adult Care Home Facility
  • Raleigh, NC
National Provider Identifier
1922128784
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
MHL-092512 Issued in NC
Legal business name
EAGLE HOME 2
Practice address
3300 N New Hope Rd
Raleigh, NC 27604-4952
Phone
(919) 872-1105
Fax
(919) 872-1105
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, RN
Title
Administrator
Phone
(919) 872-7686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X MHL-092512 NC Primary

Addresses

Primary practice location

3300 N New Hope Rd
Raleigh, NC 27604-4952

Mailing address

3300 N New Hope Rd
Raleigh, NC 27604-4952
Phone (919) 872-1105

Other identifiers 1

IdentifierTypeStateIssuer
7804642MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Eagle Healthcare Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1922128784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N NEW HOPE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044952",
            "telephone_number": "919-872-1105",
            "fax_number": "919-872-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N NEW HOPE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276044952",
            "telephone_number": "919-872-1105",
            "fax_number": "919-872-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HOME 2",
        "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": "919-872-7686",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-092512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804642",
            "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.