Provider Demographics
NPI:1811586837
Name:YJW EXCELLENT CARE LLC
Entity Type:Organization
Organization Name:YJW EXCELLENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOSLEIDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-613-6164
Mailing Address - Street 1:13205 SW 137TH AVE STE 126
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5334
Mailing Address - Country:US
Mailing Address - Phone:786-713-0383
Mailing Address - Fax:
Practice Address - Street 1:13205 SW 137TH AVE STE 126
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5334
Practice Address - Country:US
Practice Address - Phone:786-713-0383
Practice Address - Fax:786-250-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health