Healthcare Provider Details

I. General information

NPI: 1033177720
Provider Name (Legal Business Name): EXCELLA HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 NEW ENGLAND BUSINESS CENTER DR., SUITE 207
ANDOVER MA
01810-1071
US

IV. Provider business mailing address

6688 N CENTRAL EXPRESSWAY SUITE 1300
DALLAS TX
75206-3950
US

V. Phone/Fax

Practice location:
  • Phone: 978-388-4500
  • Fax: 978-388-8255
Mailing address:
  • Phone: 214-239-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LISA M ARBUCKLE
Title or Position: DIRECTOR, LICENSING & ENROLLMENT
Credential:
Phone: 214-239-6501