Healthcare Provider Details

I. General information

NPI: 1699002105
Provider Name (Legal Business Name): EXCEL HOME CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2009
Last Update Date: 11/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 TROPIC WIND AVE
NORTH LAS VEGAS NV
89081-2985
US

IV. Provider business mailing address

1116 TROPIC WIND AVE
NORTH LAS VEGAS NV
89081-2985
US

V. Phone/Fax

Practice location:
  • Phone: 702-743-7722
  • Fax: 702-642-5722
Mailing address:
  • Phone: 702-743-7722
  • Fax: 702-642-5722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAMELA G POWELL
Title or Position: PROJECT MANAGER
Credential:
Phone: 702-743-7722