- Enrollment id
- O20030512000011
- Enrollment state
- OH
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1215970090
- Multiple npi flag
- N
- Ccn
- 368044
- Associate id
- 9133039803
- Organization name
- EXCEL HEALTH SERVICES LLC
- Incorporation date
- 2002-08-13
- Incorporation state
- OH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 4889 SINCLAIR RD
- Address line 2
- STE 115
- City
- COLUMBUS
- State
- OH
- Zip code
- 432295433