Provider Demographics
NPI:1730569443
Name:EXCEL INTERVENTION AND THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:EXCEL INTERVENTION AND THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:HARDIN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS PSY
Authorized Official - Phone:757-207-0936
Mailing Address - Street 1:PO BOX 632
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-0632
Mailing Address - Country:US
Mailing Address - Phone:757-207-0936
Mailing Address - Fax:
Practice Address - Street 1:8545 MARY BALL RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:VA
Practice Address - Zip Code:22503-2523
Practice Address - Country:US
Practice Address - Phone:757-207-0936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2493253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care