Provider Demographics
NPI:1780208660
Name:EXCEL FAMILY SERVICES OF VIRGINIA, LLC
Entity Type:Organization
Organization Name:EXCEL FAMILY SERVICES OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-724-1704
Mailing Address - Street 1:1931 CRANBORNE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-7056
Mailing Address - Country:US
Mailing Address - Phone:757-724-1704
Mailing Address - Fax:
Practice Address - Street 1:1100 HUBBELL DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5633
Practice Address - Country:US
Practice Address - Phone:757-724-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities