NPI 1114755923

Eagle Therapy LLC

Organisation Developmental Disabilities Clinic/Center Roseville, MN

Practice location

Address: 2745 Herschel St N A109, Roseville, MN 55113
Phone: (614) 596-3566
Mailing address: 3800 American Blvd W STE 1500, Bloomington, MN 55431-4429

Authorised official

Name: Omar Eleye
Title: Ceo
Phone: (614) 596-3566

Registered specialties (2)

Developmental Disabilities Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD1600X

Other Clinic/Center providers in Minnesota →

Early Intervention Provider Agency

Agencies Taxonomy 252Y00000X

Other Early Intervention Provider Agency providers in Minnesota →

Registry record

NPI: 1114755923
Entity type: Organization
NPI issued: 23 Jul 2024
Record last updated: 23 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.