Provider Demographics
NPI:1033177720
Name:EXCELLA HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EXCELLA HEALTHCARE, INC.
Other - Org Name:ENCOMPASS HOME HEALTH OF NEW ENGLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, LICENSING & ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARBUCKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-239-6501
Mailing Address - Street 1:6688 N CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3950
Mailing Address - Country:US
Mailing Address - Phone:214-239-6500
Mailing Address - Fax:
Practice Address - Street 1:35 NEW ENGLAND BUSINESS CENTER DR., SUITE 207
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1071
Practice Address - Country:US
Practice Address - Phone:978-388-4500
Practice Address - Fax:978-388-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA626465OtherHARVARD PILGRIM HEALTHCAR
MA9729020Medicaid
MAY61335OtherBLUE CROSS PT
MA694563OtherTUFTS HEALTH PLAN
MAOG0009OtherBLUE CROSS OT
MA694563OtherTUFTS HEALTH PLAN
MA9729020Medicaid