Provider Demographics
NPI:1205316353
Name:EXCELLENT CARE ADVOCACY LLC
Entity type:Organization
Organization Name:EXCELLENT CARE ADVOCACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:NORFORD
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH ADVOCATE
Authorized Official - Phone:336-697-2291
Mailing Address - Street 1:5804 BARBELL CIR
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9211
Mailing Address - Country:US
Mailing Address - Phone:336-697-2291
Mailing Address - Fax:
Practice Address - Street 1:5804 BARBELL CIR
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9211
Practice Address - Country:US
Practice Address - Phone:336-697-2291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1727681251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1727681Medicaid