Provider Demographics
NPI:1720788656
Name:EXCEL GROUP SERVICES
Entity Type:Organization
Organization Name:EXCEL GROUP SERVICES
Other - Org Name:EXCEL GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMELIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:301-742-9797
Mailing Address - Street 1:911 BIRCH ST NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4519
Mailing Address - Country:US
Mailing Address - Phone:703-743-0911
Mailing Address - Fax:
Practice Address - Street 1:911 BIRCH ST NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4519
Practice Address - Country:US
Practice Address - Phone:703-743-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities