Provider Demographics
NPI:1205191707
Name:EXCEL HOME HEALTH CARE L.P.
Entity Type:Organization
Organization Name:EXCEL HOME HEALTH CARE L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR OF NURSING
Authorized Official - Phone:314-361-7775
Mailing Address - Street 1:4 CROOKHAM CT
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-4801
Mailing Address - Country:US
Mailing Address - Phone:314-361-7775
Mailing Address - Fax:314-361-7776
Practice Address - Street 1:5622 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2600
Practice Address - Country:US
Practice Address - Phone:314-361-7775
Practice Address - Fax:314-361-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1518189141Medicaid