Provider Demographics
NPI:1568898567
Name:EXCEL BEHAVIORAL & COMMUNITY SERVICES
Entity Type:Organization
Organization Name:EXCEL BEHAVIORAL & COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-372-5519
Mailing Address - Street 1:2401 W BONANZA RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4774
Mailing Address - Country:US
Mailing Address - Phone:702-372-5519
Mailing Address - Fax:
Practice Address - Street 1:2401 W BONANZA RD
Practice Address - Street 2:SUITE L
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4774
Practice Address - Country:US
Practice Address - Phone:702-372-5519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCEL EXTENDED CARE ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness