Provider Demographics
NPI:1205228335
Name:LA EXCEL CARE INC
Entity Type:Organization
Organization Name:LA EXCEL CARE INC
Other - Org Name:TEXAS EXCEL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNET
Authorized Official - Prefix:
Authorized Official - First Name:DICKSON
Authorized Official - Middle Name:E
Authorized Official - Last Name:IDUSUYI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-361-0219
Mailing Address - Street 1:4348 S JEFFREY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4196
Mailing Address - Country:US
Mailing Address - Phone:225-361-0219
Mailing Address - Fax:225-361-0483
Practice Address - Street 1:4338 S JEFFREY DR # 102
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4196
Practice Address - Country:US
Practice Address - Phone:225-361-0219
Practice Address - Fax:225-361-0483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)