Provider Demographics
NPI:1558566893
Name:EXCELCARE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:EXCELCARE HEALTH SERVICES, LLC
Other - Org Name:EXCELCARE NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-902-0200
Mailing Address - Street 1:21 EASTBROOK BND STE 110
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1546
Mailing Address - Country:US
Mailing Address - Phone:678-902-0200
Mailing Address - Fax:678-902-0201
Practice Address - Street 1:3200 SHAKERAG HILL SUITE B
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:678-902-0200
Practice Address - Fax:678-902-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056-R-0206251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA668077693BMedicaid