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General NPI Number Information
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NPI Number | 1033930581
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Entity Type | Organization
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Legal Business Name | EXCELLENT LIFE HOME SERVICES, LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 5539 LAUREL HALL DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-2302
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Country | US
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Telephone | 317-812-7797
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Fax |
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Provider Business Mailing Address
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Address Line | 260 RIDGE POINTE DR
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City | COVINGTON
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State | GA
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Zip | 30016-4744
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Country | US
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Telephone | 678-794-2673
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LACHELLE DENISE WILLIAMS
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Credential | LPN
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Telephone | 678-794-2637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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