Healthcare Provider Details

I. General information

NPI: 1982306031
Provider Name (Legal Business Name): EXCEL CAREGIVERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31217 WILLOW CT
FORISTELL MO
63348-2556
US

IV. Provider business mailing address

31B ALLEN AVE
WEBSTER GROVES MO
63119-2305
US

V. Phone/Fax

Practice location:
  • Phone: 314-968-2273
  • Fax: 314-985-1039
Mailing address:
  • Phone: 314-968-2273
  • Fax: 314-985-1039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: EUGENE DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 314-968-2273