Provider Demographics
NPI:1639123888
Name:EXCEL HOME CARE, INC.
Entity Type:Organization
Organization Name:EXCEL HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-863-0099
Mailing Address - Street 1:1565 MAIN ST
Mailing Address - Street 2:BLDG 2 STE 301
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2085
Mailing Address - Country:US
Mailing Address - Phone:978-863-0099
Mailing Address - Fax:978-851-5192
Practice Address - Street 1:1565 MAIN ST
Practice Address - Street 2:BLDG 2 STE 301
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-2085
Practice Address - Country:US
Practice Address - Phone:978-863-0099
Practice Address - Fax:978-851-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0607142Medicaid
MA0607142Medicaid