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General NPI Number Information
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NPI Number | 1518202142
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Entity Type | Organization
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Legal Business Name | EXCELSIS HOME HEALTH CARE,INC
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Dates
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Enumeration Date | 12/08/2012
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Last Update Date | 12/08/2012
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Provider Practice Location Address
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Address Line | 13 W US HIGHWAY 30 SUITE 203
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2266
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Country | US
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Telephone | 219-322-0400
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Fax | 219-322-0420
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Provider Business Mailing Address
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Address Line | 13 W US HIGHWAY 30 SUITE 203
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City | SCHERERVILLE
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State | IN
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Zip | 46375-2266
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Country | US
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Telephone | 219-322-0400
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Fax | 219-322-0420
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOCELYN MATIAS
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Credential | RN
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Telephone | 219-322-0400
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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 | IN
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