EAGLE THERAPY LLC – NPI #1114755923
Clinic/Center

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

Health Care Provider Taxonomy Code for Clinic/Center

EAGLE THERAPY LLC is an AHC clinic located in ROSEVILLE, MN. NPPES has assigned the NPI number 1114755923 to EAGLE THERAPY LLC on July 23, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QD1600X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Developmental Disabilities

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAGLE THERAPY LLC below.

NPI Profile for
EAGLE THERAPY LLC

NPI Number
1114755923
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAGLE THERAPY LLC
Primary location
2745 HERSCHEL ST N
A109
ROSEVILLE, MN 55113
Phone: (614) 596-3566 Fax:
Mailing address
3800 AMERICAN BLVD W STE 1500
BLOOMINGTON, MN 55431-4429
Phone: (614) 596-3566 Fax:
Organization Subpart
No
Authorized Official
OMAR ELEYE
CEO
Phone: (614) 596-3566
Updated
Certification Date
Jul 13, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD1600X
- Clinic/Center / Developmental Disabilities (Primary)
252Y00000X
- Early Intervention Provider Agency

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.