Provider Demographics
NPI:1528395381
Name:EXCEL HOME CARE AGENCY
Entity Type:Organization
Organization Name:EXCEL HOME CARE AGENCY
Other - Org Name:EXCEL EXTENDED CARE ORGANIZATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PROJECT MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-655-7466
Mailing Address - Street 1:800 N RAINBOW BLVD
Mailing Address - Street 2:STE 158
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1189
Mailing Address - Country:US
Mailing Address - Phone:702-655-7466
Mailing Address - Fax:702-642-5722
Practice Address - Street 1:4440 S MARYLAND PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7527
Practice Address - Country:US
Practice Address - Phone:702-655-7466
Practice Address - Fax:702-642-5722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-14
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101Y00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty