Provider Demographics
NPI:1508388067
Name:EXCELLENT COMMUNITY SERVICES INC.
Entity Type:Organization
Organization Name:EXCELLENT COMMUNITY SERVICES INC.
Other - Org Name:EXCELLENT DAY HABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:OLANIYI
Authorized Official - Last Name:OGUNTIMEHIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:240-552-4551
Mailing Address - Street 1:4229 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-4835
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4229 3RD ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4835
Practice Address - Country:US
Practice Address - Phone:202-760-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELLENT COMMUNITY SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services