Provider Demographics
NPI:1699124636
Name:EXCEL HOMECARE GROUP
Entity type:Organization
Organization Name:EXCEL HOMECARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYAHUNGUWO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-782-9374
Mailing Address - Street 1:824 N JOHN YOUNG PKWY
Mailing Address - Street 2:UNIT D
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4912
Mailing Address - Country:US
Mailing Address - Phone:407-782-9374
Mailing Address - Fax:
Practice Address - Street 1:824 N JOHN YOUNG PKWY
Practice Address - Street 2:UNIT D
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4912
Practice Address - Country:US
Practice Address - Phone:407-782-9374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL234414251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health