| Eagle Wings, Llc | |
|
1020 Long Blvd #5 Lansing MI 48911-6896 | |
| (517) 420-6123 | |
| Not Available |
| Full Name | Eagle Wings, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1020 Long Blvd, Lansing, Michigan |
| Authorized Official Name and Position | David J Brock (OWNER) |
| Authorized Official Contact | 5174206123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Wings, Llc 1538 Stoney Pt Lansing MI 48917-1450 Ph: (517) 323-8395 | Eagle Wings, Llc 1020 Long Blvd #5 Lansing MI 48911-6896 Ph: (517) 420-6123 |
| NPI Number | 1891947248 |
|---|---|
| Provider Enumeration Date | 10/16/2008 |
| Last Update Date | 10/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891947248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 6301005177 (Michigan) | Primary |
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