Eagle Therapy LLC

NPI #1114755923 in Roseville, Minnesota

Provider Information

NPI Number: 1114755923
Entity Type: Organization
Organization Name: Eagle Therapy LLC
Primary Specialty: Clinic/Center - Developmental Disabilities
Enumeration Date: Jul 23, 2024
Last Updated: Jul 23, 2024

Practice Location

Address: 2745 HERSCHEL ST N
Address 2: A109
City: Roseville
State: Minnesota
ZIP Code: 55113
Phone: (614) 596-3566

Authorized Official

Name: OMAR ELEYE
Title: CEO
Phone: (614) 596-3566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Early Intervention Provider Agency	252Y00000X
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X	Primary

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