Provider Demographics
NPI:1831603059
Name:EXCELLENT INC.
Entity type:Organization
Organization Name:EXCELLENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:313-460-1809
Mailing Address - Street 1:19319 BIRCHRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5837
Mailing Address - Country:US
Mailing Address - Phone:313-460-1809
Mailing Address - Fax:248-223-9105
Practice Address - Street 1:20200 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-1380
Practice Address - Country:US
Practice Address - Phone:313-341-2723
Practice Address - Fax:313-341-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty