Provider Demographics
NPI:1346719044
Name:EXCELLENCE LEARNING INSPIRING SUPPORTIVE ASSOCIATE LLC
Entity Type:Organization
Organization Name:EXCELLENCE LEARNING INSPIRING SUPPORTIVE ASSOCIATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-268-0798
Mailing Address - Street 1:6 CARTER PL
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1604
Mailing Address - Country:US
Mailing Address - Phone:908-268-0798
Mailing Address - Fax:
Practice Address - Street 1:6 CARTER PL
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1604
Practice Address - Country:US
Practice Address - Phone:908-268-0798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty