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General NPI Number Information
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NPI Number | 1821954678
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Entity Type | Organization
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Legal Business Name | EXCELSIOR NEXTGEN CENTER LLC
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Dates
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Enumeration Date | 12/24/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 572 S NELSON RD STE C
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City | COLUMBUS
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State | OH
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Zip | 43205-2577
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Country | US
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Telephone | 614-379-1490
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Fax |
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Provider Business Mailing Address
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Address Line | 572 S NELSON RD STE C
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City | COLUMBUS
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State | OH
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Zip | 43205-2577
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Country | US
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Telephone | 614-379-1490
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORA T STROUD
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Credential | CM
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Telephone | 614-397-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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