Eagles Wellness Center

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EAGLES WELLNESS CENTER

Practice address

1300 Mercantile LN Ste 100K
Largo, MD 20774-5390

Phone

(301) 636-0977

Fax

(240) 219-4377

NPI assigned

Jun 7, 2023

Organization subpart

No

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

Authorized official

Name

Deaniece Fields

Title

Cfo

Phone

(240) 832-4007

Specialties & licenses 1

Addresses

Tax ID family

Eagles Wellness Center2 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.

• Eagles Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Largo, MD
  • NPI 1215745179
  NPD tax ID

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1962196386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13602 GENTRY CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081330",
            "telephone_number": "240-832-4007",
            "fax_number": "240-219-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN STE 100K",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745390",
            "telephone_number": "301-636-0977",
            "fax_number": "240-219-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLES WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "DEANIECE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "240-832-4007"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• E-Generation (Integrated Care Management)
• E-Generation (Integrated Care Management)
• E-Generation (Integrated Care Management)
• E-Generation (Integrated Care Management)
• Eagles Wellness Center
• Marie Ann Eason, M.D.
• East Coast Gastroenterology LLC
• Tamara Renita Easton, PA
• Ebed Community Improvement Inc.
• Linda Uwanaka Ebonine, PA-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Largo, MD
• Providers in Largo, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.