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General NPI Number Information
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NPI Number | 1508940685
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Entity Type | Organization
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Legal Business Name | THE EXCEL GROUP
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 3180 E 40TH ST
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City | YUMA
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State | AZ
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Zip | 85365-7772
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Country | US
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Telephone | 928-341-0335
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Fax | 928-344-9120
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Provider Business Mailing Address
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Address Line | 3250A E 40TH ST
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City | YUMA
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State | AZ
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Zip | 85365-7748
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Country | US
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Telephone | 928-641-0335
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Fax | 928-539-7099
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Authorized Official
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Title or Position | CEO
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Name | MS. CAROL A. CARR VIII
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Credential |
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Telephone | 928-341-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | BH-1554
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License Number State | AZ
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