MEDICARE: EXCELLENT HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	0348	DC

General Provider Information

NPI Number	:	1033241278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELLENT HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	7826 EASTERN AVE NW
Second Line	:	SUITE LL8
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1324
Country	:	US
Telephone Number	:	202-722-7280
Fax Number	:	202-722-1230

Provider Business Practice Location Address
First Line	:	7826 EASTERN AVE NW
Second Line	:	SUITE LL8
City	:	WASHINGTON
State	:	DC
Zip	:	20012-1324
Country	:	US
Telephone Number	:	202-722-7280
Fax Number	:	202-722-1230

Authorized Official
Title or Position	:	CEO
Name	:	MISS JACQUELYN DELOIS LITTLE
Credential	:
Telephone Number	:	240-715-8810

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/09/2008

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