Healthcare Provider Details

I. General information

NPI: 1568898567
Provider Name (Legal Business Name): EXCEL BEHAVIORAL & COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BONANZA RD SUITE L
LAS VEGAS NV
89106-4774
US

IV. Provider business mailing address

2401 W BONANZA RD SUITE L
LAS VEGAS NV
89106-4774
US

V. Phone/Fax

Practice location:
  • Phone: 702-372-5519
  • Fax:
Mailing address:
  • Phone: 702-372-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBBIE EVANS
Title or Position: OWNER
Credential:
Phone: 702-372-5519