Provider Demographics
NPI:1043928633
Name:EXCEL IN CARE HOME HEALTH AGENCY, LLC
Entity type:Organization
Organization Name:EXCEL IN CARE HOME HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:MARKETA
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-725-1018
Mailing Address - Street 1:819 WALNUT PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4159
Mailing Address - Country:US
Mailing Address - Phone:757-725-1018
Mailing Address - Fax:757-970-0909
Practice Address - Street 1:819 WALNUT PARK DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4159
Practice Address - Country:US
Practice Address - Phone:757-725-1018
Practice Address - Fax:757-970-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health