Provider Demographics
NPI:1205629839
Name:EXCEL HEARTS HOME CARE LLC
Entity type:Organization
Organization Name:EXCEL HEARTS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATRICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEWSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:463-867-8802
Mailing Address - Street 1:4539 N 22ND ST STE R
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4639
Mailing Address - Country:US
Mailing Address - Phone:463-867-8802
Mailing Address - Fax:317-463-1912
Practice Address - Street 1:4539 N 22ND ST STE R
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4639
Practice Address - Country:US
Practice Address - Phone:463-867-8802
Practice Address - Fax:317-463-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care