Eeagles Nest LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

EEAGLES NEST LLC

Practice address

1601 Tewksbury CT
Virginia Beach, VA 23456-4864

Phone

(757) 351-6255

NPI assigned

Mar 28, 2024

Organization subpart

No

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

Authorized official

Name

Roosevelt Owens

Title

Owner

Phone

(757) 694-1669

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1982455820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 STEELEMAN LN",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205053",
            "telephone_number": "757-694-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TEWKSBURY CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564864",
            "telephone_number": "757-351-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EEAGLES NEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "ROOSEVELT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-694-1669"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.