Provider Demographics
NPI:1003845124
Name:EXCEL CARE INC.
Entity Type:Organization
Organization Name:EXCEL CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GENNET
Authorized Official - Middle Name:
Authorized Official - Last Name:YOHANNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-340-5106
Mailing Address - Street 1:6322 SOVEREIGN ST
Mailing Address - Street 2:#141
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5142
Mailing Address - Country:US
Mailing Address - Phone:210-340-5106
Mailing Address - Fax:210-340-1542
Practice Address - Street 1:6322 SOVEREIGN ST
Practice Address - Street 2:#141
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5142
Practice Address - Country:US
Practice Address - Phone:210-340-5106
Practice Address - Fax:210-340-1542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002048251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677221Medicare ID - Type Unspecified