NPIMap

Organization Active NPI

Eagle Home 3

  • Adult Care Home Facility
  • Raleigh, NC
National Provider Identifier
1962522748
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
MHL092559 Issued in NC
Legal business name
EAGLE HOME 3
Practice address
5800 Brambleton Ave
Raleigh, NC 27610-5581
Phone
(919) 773-2276
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 MHL092559 NC Primary

Addresses

Primary practice location

5800 Brambleton Ave
Raleigh, NC 27610-5581

Mailing address

5800 Brambleton Ave
Raleigh, NC 27610-5581
Phone (919) 773-2276

Other identifiers 1

IdentifierTypeStateIssuer
7804863MedicaidNC

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": "1722384000000",
    "number": "1962522748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 BRAMBLETON AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105581",
            "telephone_number": "919-773-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 BRAMBLETON AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276105581",
            "telephone_number": "919-773-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HOME 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "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": "MHL092559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804863",
            "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 Jul 31, 2024; 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.