Provider Demographics
NPI:1477099117
Name:EAGLE COLLEGE PREP ENDEAVOR
Entity type:Organization
Organization Name:EAGLE COLLEGE PREP ENDEAVOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-503-2239
Mailing Address - Street 1:2617 SHENANDOAH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-2311
Mailing Address - Country:US
Mailing Address - Phone:314-450-7651
Mailing Address - Fax:314-735-4471
Practice Address - Street 1:2617 SHENANDOAH AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-2311
Practice Address - Country:US
Practice Address - Phone:314-450-7651
Practice Address - Fax:314-735-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)