Provider Demographics
NPI:1992161186
Name:EXCELLENT HEALTHCARE NURSING SERVICES, INC.
Entity type:Organization
Organization Name:EXCELLENT HEALTHCARE NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MR
Authorized Official - First Name:INNOCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPUAKA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:410-984-7411
Mailing Address - Street 1:6817 REAL PRINCESS LN
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4493
Mailing Address - Country:US
Mailing Address - Phone:410-984-7411
Mailing Address - Fax:410-645-8828
Practice Address - Street 1:6817 REAL PRINCESS LN
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-4493
Practice Address - Country:US
Practice Address - Phone:410-984-7411
Practice Address - Fax:410-645-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3805251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care