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General NPI Number Information
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NPI Number | 1417440769
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Entity Type | Organization
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Legal Business Name | EXCEL
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 1000 ATLANTIC AVE STE 302
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City | CAMDEN
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State | NJ
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Zip | 08104-1132
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Country | US
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Telephone | 856-541-9212
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Fax | 856-797-4830
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Provider Business Mailing Address
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Address Line | 1000 ATLANTIC AVE STE 302
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City | CAMDEN
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State | NJ
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Zip | 08104-1132
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Country | US
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Telephone | 856-541-9212
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Fax | 856-797-4830
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNIFER DOWDELL
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Credential | LCSW
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Telephone | 856-541-9212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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