EXCELSIOR SERVICES GROUP LLC (NPI# 1003413311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003413311 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR SERVICES GROUP LLC |
| Practice Address |
415 Main Ave Wood Ridge NJ 07075-2055 |
| Mailing Address |
91 Helen Ct Franklin Lakes NJ 07417-2015 |
| Practice Telephone | 9174636166 |
| Mailing Telephone | 9174636166 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | MONICA ELKESHK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9174636166 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
415 MAIN AVE |
| City | WOOD RIDGE |
| State | NJ |
| Zip Code | 07075-2055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467992156 | Jeremy Thomas Goldklang | Specialist/Technologist | 218 Jay Street, Wood Ridge, NJ 07075 | 2017-03-01 |
| 1003290420 | Samantha Goldklang | Nurse Practitioner | 218 Jay St, Wood-ridge, NJ 07075 | 2015-07-15 |
| 1891183133 | Meaghan Durham | Specialist/Technologist | 29 Wesmont Drive, Wood Ridge, NJ 07075 | 2015-01-08 |
| 1831473065 | Juan A Castro | Behavioral Analyst | 358 Hackensack Street, D, Wood-ridge, NJ 07075 | 2011-10-06 |
| 1568600443 | Jamea R. Olivari | Dentist | 163 Valley Blouevard, Wood Ridge, NJ 07075 | 2009-01-30 |
| 1518979186 | Theodore Paul Masotti | Pharmacist | 211 Hackensack Street, Wood Ridge, NJ 07075 | 2006-08-12 |
| 1841405008 | Maria Vita Pantano | Family Medicine | 245 Valley Blvd, Wood Ridge, NJ 07075 | 2007-05-11 |
| 1427541929 | Lisandra Quinoy Pena | Dentist | 300 Avalon Dr Unit 3244, Wood Ridge, NJ 07075-1015 | 2018-06-08 |
| 1114324308 | Myong Sun Choe | General Acute Care Hospital | 300 Avalon Dr Unit 3306, Wood Ridge, NJ 07075-1024 | 2014-12-03 |
| 1649539248 | Yihao Jiang | Anesthesiology | 401 Avalon Dr Unit 4212, Wood Ridge, NJ 07075-1059 | 2012-05-16 |
| Find all providers in zip 07075 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470758 | Reed Next, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 100 Rosie Sq, Wood Ridge, NJ 07075-7001 | 2020-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871559 | Heart To Heart Health Care Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 Mamie Ct, Brick, NJ 08723-6438 | 2020-11-06 |
| 1316548167 | The Arc of Cape May County, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 E Woodland Ave, Cape May Court House, NJ 08210-3815 | 2020-11-06 |
| 1730789447 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 209 Loganberry Ln, Freehold, NJ 07728-4045 | 2020-10-30 |
| 1881294858 | Youth Consultation Service Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 Echohill Ln, Willingboro, NJ 08046-2205 | 2020-10-29 |
| 1093314759 | Fordham-lewis Consulting, L.L.C. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 94 Ramapo Valley Rd, Mahwah, NJ 07430-1161 | 2020-10-22 |
| 1487252177 | Heart To Heart Health Care Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1476 W Terrace Cir Apt 2, Teaneck, NJ 07666-5230 | 2020-10-14 |
| 1215535422 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 231 Griggstown Rd, Belle Mead, NJ 08502-5204 | 2020-10-12 |
| 1659988178 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Heather Ln, Belle Mead, NJ 08502-5125 | 2020-09-29 |
| 1598372021 | Community Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 838 Long Road, Gillete, NJ 07933-0854 | 2020-09-29 |
| 1760099170 | Constructive Aba Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 217 Autumn St # 2, Passaic, NJ 07055-4305 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
| City | WOOD RIDGE |
| Zip Code | 07075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.