Provider Demographics
NPI:1699002105
Name:EXCEL HOME CARE AGENCY
Entity Type:Organization
Organization Name:EXCEL HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-743-7722
Mailing Address - Street 1:1116 TROPIC WIND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-2985
Mailing Address - Country:US
Mailing Address - Phone:702-743-7722
Mailing Address - Fax:702-642-5722
Practice Address - Street 1:1116 TROPIC WIND AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-2985
Practice Address - Country:US
Practice Address - Phone:702-743-7722
Practice Address - Fax:702-642-5722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency