Provider Demographics
NPI:1831593441
Name:EXCELLENT CARE SERVICES INC.
Entity type:Organization
Organization Name:EXCELLENT CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINBOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-289-0338
Mailing Address - Street 1:3003 43RD ST NW
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7037
Mailing Address - Country:US
Mailing Address - Phone:507-289-0338
Mailing Address - Fax:
Practice Address - Street 1:3003 43RD ST NW
Practice Address - Street 2:SUITE 106
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-7037
Practice Address - Country:US
Practice Address - Phone:507-289-0338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN366892251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN366892OtherMINNESOTA DEPARTMENT OF HEALTH
MNA837683000Medicaid
MNA787675100Medicaid
MNA812373000Medicaid