Healthcare Provider Details

I. General information

NPI: 1124223284
Provider Name (Legal Business Name): EXCELCARE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SHAKERAG HL SUITE B
PEACHTREE CITY GA
30269-6511
US

IV. Provider business mailing address

3200 SHAKERAG HL SUITE B
PEACHTREE CITY GA
30269-6511
US

V. Phone/Fax

Practice location:
  • Phone: 678-902-0200
  • Fax: 678-902-0201
Mailing address:
  • Phone: 678-902-0200
  • Fax: 678-902-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN179142
License Number StateGA

VIII. Authorized Official

Name: MRS. ANGELLA FRANCIS
Title or Position: CHIEF NURSING OFFICER
Credential: RN
Phone: 678-902-0200