Provider Demographics
NPI:1629753744
Name:EAGER CARE PLACE LLC
Entity Type:Organization
Organization Name:EAGER CARE PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FABVIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINT JUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:786-744-0525
Mailing Address - Street 1:1154 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5405
Mailing Address - Country:US
Mailing Address - Phone:786-744-0525
Mailing Address - Fax:407-601-3127
Practice Address - Street 1:5920 LONG PEAK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-3244
Practice Address - Country:US
Practice Address - Phone:786-744-0525
Practice Address - Fax:407-601-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities