Provider Demographics
NPI:1982987434
Name:EAGLE HOMECARE AGENCY,INC
Entity Type:Organization
Organization Name:EAGLE HOMECARE AGENCY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDENT
Authorized Official - Prefix:
Authorized Official - First Name:YACUN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-415-4001
Mailing Address - Street 1:3712 PRINCE ST FL 1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4429
Mailing Address - Country:US
Mailing Address - Phone:718-886-1698
Mailing Address - Fax:718-353-2696
Practice Address - Street 1:37-12 PRINCE STREET. 1FL
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4471
Practice Address - Country:US
Practice Address - Phone:718-886-1698
Practice Address - Fax:718-353-2696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0769L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health