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General NPI Number Information
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NPI Number | 1790424810
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Entity Type | Organization
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Legal Business Name | EXCEL BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 05/27/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 460 N MESA DR STE 115
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City | MESA
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State | AZ
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Zip | 85201-5974
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Country | US
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Telephone | 480-331-8521
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Fax |
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Provider Business Mailing Address
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Address Line | 625 N HAMILTON ST UNIT 53
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City | CHANDLER
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State | AZ
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Zip | 85225-3996
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Country | US
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Telephone | 480-331-5002
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | LADY ESTHER AGYEPONG
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Credential | LCSW
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Telephone | 480-331-8521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 261QM0850X
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Taxonomy Name | Adult Mental Health 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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