| The Eagles Nest Family And Children Services Llc | |
|
900 A South Main Street Suite 105 Bel Air MD 21014 | |
| (410) 914-4012 | |
| (410) 914-4013 |
| Full Name | The Eagles Nest Family And Children Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 900 A South Main Street, Bel Air, Maryland |
| Authorized Official Name and Position | Wanda Elizabeth Jackson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4439104797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Eagles Nest Family And Children Services Llc 4006 Jeffery Court Abingdon MD 21009-3073 Ph: (443) 910-4797 | The Eagles Nest Family And Children Services Llc 900 A South Main Street Suite 105 Bel Air MD 21014 Ph: (410) 914-4012 |
| NPI Number | 1629364666 |
|---|---|
| Provider Enumeration Date | 06/28/2011 |
| Last Update Date | 06/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629364666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC3588 (Maryland) | Primary |
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