Provider Demographics
NPI:1568986859
Name:AMERICAN EAGLE WOODLAND TOWERS LLC
Entity Type:Organization
Organization Name:AMERICAN EAGLE WOODLAND TOWERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-222-5275
Mailing Address - Street 1:3819 HAWK CREST RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4246
Mailing Address - Country:US
Mailing Address - Phone:734-222-5275
Mailing Address - Fax:
Practice Address - Street 1:113 W CHIPOLA AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7512
Practice Address - Country:US
Practice Address - Phone:386-738-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility