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1326267055

NPI Code Detail

MEDICARE: EXCELSIOR WELLNESS

MEDICARE: EXCELSIOR WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	32 0893 00 / 181	WA
2	323P00000X	Psychiatric Residential Treatment Facility	32 0893 00 / 181	WA
3	3245S0500X	Children's Substance Abuse Rehabilitation Facility	32 0893 00 / 181	WA
4	251B00000X	Case Management Agency	32 0893 00 / 181	WA
5	251C00000X	Developmentally Disabled Services Day Training Agency	32 0893 00 / 181	WA
6	261QM0855X	Adolescent and Children Mental Health Clinic/Center	32 0893 00 / 181	WA
7	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	32 0893 00 / 181	WA
8	320800000X	Mental Illness Community Based Residential Treatment Facility	32 0893 00 / 181	WA
9	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	32 0893 00 / 181	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326267055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELSIOR WELLNESS

Provider Business Mailing Address
First Line	:	3754 W INDIAN TRAIL RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4736
Country	:	US
Telephone Number	:	509-559-3100
Fax Number	:	509-328-7582

Provider Business Practice Location Address
First Line	:	3754 W INDIAN TRAIL RD
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99208-4736
Country	:	US
Telephone Number	:	509-328-7041
Fax Number	:	509-328-7582

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	ANDREW R HILL
Credential	:	MS, LMHC, CMHS, RRT
Telephone Number	:	509-328-7041

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	09/28/2021

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1649574187 — CATRINA ANN SWITZER
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1982995288 — EXCELSIOR WELLNESS
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Directions to “EXCELSIOR WELLNESS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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