Provider Demographics
NPI:1659517829
Name:EAGLE ADVANTAGE ACADEMY, INC.
Entity Type:Organization
Organization Name:EAGLE ADVANTAGE ACADEMY, INC.
Other - Org Name:ADVANTAGE ACADEMY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/SUPERINDENTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-276-5800
Mailing Address - Street 1:4011 JOSEPH HARDIN DR STE F
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75236-1507
Mailing Address - Country:US
Mailing Address - Phone:214-276-5846
Mailing Address - Fax:214-467-4499
Practice Address - Street 1:4011 JOSEPH HARDIN DR STE F
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-1507
Practice Address - Country:US
Practice Address - Phone:214-276-5846
Practice Address - Fax:214-467-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX057806251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)