MEDICARE: EXCEPTIONAL EMPLOYMENT SERVICES, INC.

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	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1922160571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEPTIONAL EMPLOYMENT SERVICES, INC.

Provider Business Mailing Address
First Line	:	2621 RIDGEPOINT DR STE 130
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-5224
Country	:	US
Telephone Number	:	512-482-8778
Fax Number	:	512-926-5773

Provider Business Practice Location Address
First Line	:	2621 RIDGEPOINT DR STE 130
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78754-5224
Country	:	US
Telephone Number	:	512-482-8778
Fax Number	:	512-926-5773

Authorized Official
Title or Position	:	CO-OWNER
Name	:	KIM D STEVENSON
Credential	:
Telephone Number	:	512-482-8778

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	04/01/2021

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