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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
1251K00000XPublic Health or Welfare Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

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

General Provider Information

NPI Number : 1982995288
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 : PRESIDENT/CHIEF EXECUTIVE OFFICER
Name : MR. ANDREW R HILL
Credential : MS, LMHC, CMHS, RRT
Telephone Number : 509-559-3100
Provider Enumeration Date : 04/21/2011
Last Update Date : 09/16/2022

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99208-4736
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1235322041 — LISA A FAILLERS LMFT
Practice Location Address:
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SPOKANE, WA
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1649574187 — CATRINA ANN SWITZER
Practice Location Address:
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1760761993 — LEE SCOTT MILLER LMHC
Practice Location Address:
3754 W INDIAN TRAIL RD
SPOKANE, WA
99208-4736
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Practice Fax:

Directions to “EXCELSIOR WELLNESS ” Practice Location

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