Provider Demographics
NPI:1174396154
Name:EXCEL ALLIED HEALTH SERVICES LLC
Entity type:Organization
Organization Name:EXCEL ALLIED HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ILODIGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-559-2726
Mailing Address - Street 1:2860 FREEDOM DR # B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-3856
Mailing Address - Country:US
Mailing Address - Phone:704-900-6001
Mailing Address - Fax:704-220-0543
Practice Address - Street 1:8332 OFFICE PARK DR STE H
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-6937
Practice Address - Country:US
Practice Address - Phone:678-819-7588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility