Provider Type Icon

AMERICAN EAGLE ISLAND LAKE LLC NPI 1366920605


NPI Information

NPI: 1366920605
Provider Name: AMERICAN EAGLE ISLAND LAKE LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 10D2168252

Address:
160 ISLANDER CT
LONGWOOD, FL
ZIP 32750
Phone: (734) 418-9027
Get Directions

AMERICAN EAGLE ISLAND LAKE LLC is an assisted living facility in Longwood, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. AMERICAN EAGLE ISLAND LAKE LLC NPI is 1366920605. The provider is registered as an organization entity type.

The provider's business location address is:

160 ISLANDER CT
LONGWOOD, FL
ZIP 32750-925
Phone: (734) 418-9027

The provider's authorized official is Cory Wake .
The authorized official title is Associate and has the following contact phone number (734) 418-9027.

The CLIA number assigned to this NPI record is 10D2168252 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2018 and was last updated on 7/30/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.