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General NPI Number Information
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NPI Number | 1053824474
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Entity Type | Organization
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Legal Business Name | EXCEL COMPLETE HOME HEALTH & THERAPY SERVICES LLC
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 529 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3127
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Country | US
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Telephone | 936-634-1166
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Fax | 936-634-1562
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Provider Business Mailing Address
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Address Line | 529 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3127
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Country | US
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Telephone | 936-634-1166
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Fax | 936-634-1562
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Authorized Official
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Title or Position | OWNER
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Name | EARL DIMAANDAL
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Credential | PT
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Telephone | 936-634-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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