Provider Demographics
NPI:1215970090
Name:EXCEL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:EXCEL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-794-0006
Mailing Address - Street 1:110 POLARIS PKWY
Mailing Address - Street 2:STE 325
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8024
Mailing Address - Country:US
Mailing Address - Phone:614-794-0006
Mailing Address - Fax:614-794-2735
Practice Address - Street 1:110 POLARIS PKWY
Practice Address - Street 2:STE 325
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8024
Practice Address - Country:US
Practice Address - Phone:614-794-0006
Practice Address - Fax:614-794-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200220000574251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2469029Medicaid
OH2469029Medicaid