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General NPI Number Information
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NPI Number | 1700436813
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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 | 09/19/2019
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 4002 W BELVEDERE AVE UNIT A
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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 | 410-984-7411
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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 | 410-645-8828
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Authorized Official
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Title or Position | CEO
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Name | MR. INNOCENT AKPUAKA
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Credential | REGISTERED NURSE, BS
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Telephone | 410-304-6544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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