| Eagle Therapeutic Services Llc | |
|
1565 Ebenezer Rd Ste 102 Rock Hill SC 29732-2494 | |
| (980) 643-1148 | |
| Not Available |
| Full Name | Eagle Therapeutic Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1565 Ebenezer Rd Ste 102, Rock Hill, South Carolina |
| Authorized Official Name and Position | Paul Maurice Ewing (OWNER/MANAGER) |
| Authorized Official Contact | 9806431148 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Therapeutic Services Llc 677 Nannyberry Ln Concord NC 28025-9003 Ph: (336) 772-5711 | Eagle Therapeutic Services Llc 1565 Ebenezer Rd Ste 102 Rock Hill SC 29732-2494 Ph: (980) 643-1148 |
| NPI Number | 1083381297 |
|---|---|
| Provider Enumeration Date | 08/25/2021 |
| Last Update Date | 08/31/2021 |
| Certification Date | 08/31/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083381297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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