Provider Demographics
NPI:1427573195
Name:EAGLE ACQUISITION XIV LLC
Entity Type:Organization
Organization Name:EAGLE ACQUISITION XIV LLC
Other - Org Name:CONCORDIA TRANSITIONAL CARE AND REHABILITATION - BAY POINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENT
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-869-3700
Mailing Address - Street 1:1148 FIRST COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2426
Mailing Address - Country:US
Mailing Address - Phone:757-481-3321
Mailing Address - Fax:757-481-5276
Practice Address - Street 1:1148 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2426
Practice Address - Country:US
Practice Address - Phone:757-481-3321
Practice Address - Fax:757-481-5276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility