Provider Demographics
NPI:1194166991
Name:EXCELLENT SENIOR CARE
Entity type:Organization
Organization Name:EXCELLENT SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP , EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LECONTE
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN HEALTH AD
Authorized Official - Phone:347-634-2229
Mailing Address - Street 1:1488 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210
Mailing Address - Country:US
Mailing Address - Phone:347-634-2229
Mailing Address - Fax:
Practice Address - Street 1:1488 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210
Practice Address - Country:US
Practice Address - Phone:347-634-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care