Provider Demographics
NPI:1306103007
Name:EXCEL MINISTRIES' PROGRESSIVE WOMEN'S CENTER
Entity type:Organization
Organization Name:EXCEL MINISTRIES' PROGRESSIVE WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:AL
Authorized Official - Last Name:GLASTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:CBCB
Authorized Official - Phone:210-338-6580
Mailing Address - Street 1:8930 FOURWINDS DR
Mailing Address - Street 2:STE. 251
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1970
Mailing Address - Country:US
Mailing Address - Phone:210-338-6580
Mailing Address - Fax:
Practice Address - Street 1:8930 FOURWINDS DR
Practice Address - Street 2:STE. 251
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1970
Practice Address - Country:US
Practice Address - Phone:210-338-6580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIGHT MORNING STAR CHRISTIAN CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55096104100000X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty