Healthcare Provider Details

I. General information

NPI: 1992613822
Provider Name (Legal Business Name): EXCELLENCE IN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 W LEWIS ST APT 117
PASCO WA
99301-6263
US

IV. Provider business mailing address

1825 W LEWIS ST APT 117
PASCO WA
99301-6263
US

V. Phone/Fax

Practice location:
  • Phone: 509-357-4367
  • Fax:
Mailing address:
  • Phone: 509-357-4367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIO CASTILLO
Title or Position: MANAGER
Credential: CNA
Phone: 253-391-4868