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General NPI Number Information
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NPI Number | 1134089394
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Entity Type | Organization
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Legal Business Name | EAGLES WILL CO LLC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2590 WELTON ST STE 200
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City | DENVER
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State | CO
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Zip | 80205-4268
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Country | US
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Telephone | 718-871-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 38TH ST
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City | BROOKLYN
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State | NY
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Zip | 11218-3613
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Country | US
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Telephone | 917-648-4292
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL FISCHMAN
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Credential |
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Telephone | 917-648-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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