Provider Demographics
NPI:1093420010
Name:EXCELLENCE LLC
Entity Type:Organization
Organization Name:EXCELLENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL K
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-391-6104
Mailing Address - Street 1:5529 ALDRICH DR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-3111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5529 ALDRICH DR N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-3111
Practice Address - Country:US
Practice Address - Phone:701-391-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care