OrganizationActive
Eagle Therapy LLC
NPI 1114755923 · Developmental Disabilities Clinic/Center · Roseville, MN
Provider details
- NPI number
- 1114755923
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Omar Eleye, Ceo(614) 596-3566
Specialties & taxonomies
Ambulatory Health Care Facilities
- Early Intervention Provider Agency252Y00000X
Agencies
Practice location
2745 Herschel St N
A109
Roseville, MN 55113
Phone: (614) 596-3566
Approximate (ZIP-level) locationGet directions
Mailing address
3800 American Blvd W Ste 1500
Bloomington, MN 55431-4429
Registry dates
- Enumerated
- 2024-07-23
- Last updated
- 2024-07-23
- Certified
- 2024-07-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.