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General NPI Number Information
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NPI Number | 1326887878
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Entity Type | Organization
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Legal Business Name | THE EXCELLENCE EDGE LLC
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1331 BOYDS MILL RD
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City | MONETA
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State | VA
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Zip | 24121-6157
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Country | US
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Telephone | 540-529-2977
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 BOYDS MILL RD
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City | MONETA
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State | VA
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Zip | 24121-6157
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Country | US
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Telephone | 540-529-2977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA M. SHANER
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Credential | LPC
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Telephone | 540-529-2977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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