Entc LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ENTC LLC

Doing business as

Eagles Nest

Practice address

1813 Ambas Dr
Lake Havasu City, AZ 86403-7445

Phone

(928) 566-2488

NPI assigned

Aug 15, 2023

Organization subpart

No

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

Authorized official

Name

Angela Foltz

Title

President

Phone

(928) 566-2488

Specialties & licenses 1

Addresses

Other names 1

• Eagles Nest Doing business as

Locations

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1982487708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE HAVASU AVENUE, SUITE F",
            "address_2": "BOX 856",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-566-2488",
            "fax_number": "928-955-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 AMBAS DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864037445",
            "telephone_number": "928-566-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "FOLTZ",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-566-2488"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagles Nest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.