Provider Demographics
NPI:1740622794
Name:EXCEL BEHAVIORAL & COMMUNITY SERVICES, INC
Entity type:Organization
Organization Name:EXCEL BEHAVIORAL & COMMUNITY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:GIOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-358-7636
Mailing Address - Street 1:2401 W BONANZA RD
Mailing Address - Street 2:L
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4774
Mailing Address - Country:US
Mailing Address - Phone:702-372-5519
Mailing Address - Fax:702-359-0041
Practice Address - Street 1:2401 W BONANZA RD
Practice Address - Street 2:L
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4774
Practice Address - Country:US
Practice Address - Phone:702-372-5519
Practice Address - Fax:702-359-0041
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCEL EXTENDED CARE ORGANIZATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty