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General NPI Number Information
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NPI Number | 1487308565
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Entity Type | Organization
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Legal Business Name | EXCELLENT HEALTHCARE & PSYCHIATRIC REHABILITATION PROGRAM SERVICES INC
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 4000 - 4002 UNIT A W BELVEDERE AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-5502
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Country | US
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Telephone | 410-304-6544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31699
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City | GWYNN OAK
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State | MD
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Zip | 21207-8699
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Country | US
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Telephone | 410-984-7411
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | INNOCENT AKPUAKA
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Credential |
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Telephone | 410-984-7411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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