Provider Demographics
NPI:1790424810
Name:EXCEL BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:EXCEL BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LADY ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:AGYEPONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:480-331-8521
Mailing Address - Street 1:625 N HAMILTON ST UNIT 53
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-3996
Mailing Address - Country:US
Mailing Address - Phone:480-331-5002
Mailing Address - Fax:
Practice Address - Street 1:460 N MESA DR STE 115
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5974
Practice Address - Country:US
Practice Address - Phone:480-331-8521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health