Provider Demographics
NPI:1912789454
Name:FLYING EAGLE HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:FLYING EAGLE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:888-251-0563
Mailing Address - Street 1:PO BOX 2043
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02305-2043
Mailing Address - Country:US
Mailing Address - Phone:774-240-9389
Mailing Address - Fax:
Practice Address - Street 1:24 NORTH ST STE 2
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4639
Practice Address - Country:US
Practice Address - Phone:888-251-0563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health