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General NPI Number Information
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NPI Number | 1740622794
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Entity Type | Organization
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Legal Business Name | EXCEL BEHAVIORAL & COMMUNITY SERVICES, INC
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 2401 W BONANZA RD L
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City | LAS VEGAS
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State | NV
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Zip | 89106-4774
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Country | US
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Telephone | 702-372-5519
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Fax | 702-359-0041
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Provider Business Mailing Address
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Address Line | 2401 W BONANZA RD L
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City | LAS VEGAS
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State | NV
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Zip | 89106-4774
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Country | US
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Telephone | 702-372-5519
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Fax | 702-359-0041
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Authorized Official
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Title or Position | DIRECT SUPERVISOR
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Name | MISS GIOVANNA BRAGGS
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Credential |
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Telephone | 702-358-7636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State | NV
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