Provider Demographics
NPI:1124881768
Name:SOARING EAGLES HOME CARE LLC
Entity type:Organization
Organization Name:SOARING EAGLES HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANCILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLAS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, DNP
Authorized Official - Phone:954-401-8101
Mailing Address - Street 1:150 S PINE ISLAND RD STE 375
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2667
Mailing Address - Country:US
Mailing Address - Phone:954-401-8101
Mailing Address - Fax:954-906-4066
Practice Address - Street 1:150 S PINE ISLAND RD STE 375
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2667
Practice Address - Country:US
Practice Address - Phone:954-401-8101
Practice Address - Fax:954-906-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care