EXCELSIOR YOUTH CENTER (NPI# 1326267055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326267055 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR YOUTH CENTER |
| Other Organization Name | EXCELSIOR |
| Practice Address |
3754 W Indian Trail Rd Spokane WA 99208-4736 |
| Practice Telephone | 5093287041 |
| Practice Fax Number | 5093287582 |
| Mailing Telephone | 5093287041 |
| Mailing Fax Number | 5093287582 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | ANDREW R HILL (CEO/PRESIDENT) |
| Authorized Official Telephone | 5093287041 |
| Authorized Official Credential | MS, LMHC, CMHS, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
32 0893 00 / 181 | WA | Ambulatory Health Care Facilities |
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
32 0893 00 / 181 | WA | Ambulatory Health Care Facilities |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 32 0893 00 / 181 | WA | Residential Treatment Facilities |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 32 0893 00 / 181 | WA | Residential Treatment Facilities |
| N | 323P00000X | Psychiatric Residential Treatment Facility | 32 0893 00 / 181 | WA | Residential Treatment Facilities |
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
32 0893 00 | WA | Residential Treatment Facilities |
| N | 251B00000X | Case Management | 32 0893 00 / 181 | WA | Agencies |
| N | 251C00000X | Day Training, Developmentally Disabled Services | 32 0893 00 | WA | Agencies |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
32 0893 00 / 181 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 450639 | 05 | |
| WA | 1993435 | 05 | |
| WA | 1007885 | 05 | |
| WA | 2015145 | 05 |
| Other Name | Type Code |
|---|---|
| Excelsior | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982995288 | Excelsior Youth Center | Public Health or Welfare | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2011-04-21 |
| 1104124148 | Excelsior Youth Center | Community Based Residential Treatment Facility, Mental Illness | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2011-02-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EXCELSIOR YOUTH CENTER | 3754 W Indian Trail Rd, Spokane, WA 99208 |
| Street Address |
3754 W INDIAN TRAIL RD |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-4736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760435028 | Michael Jacks Mainer | Emergency Medicine | 3754 W Indian Trail Rd, Spokane, WA 99208-4700 | 2006-05-18 |
| 1376144360 | Kelsey Baycroft | Counselor | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-11-05 |
| 1881201648 | Cheri Ileen Brewster | Registered Nurse | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-09-25 |
| 1255943627 | Dylan Ramirez | Peer Specialist | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-08-18 |
| 1366069304 | Mekel Aliace Strahan | Behavior Technician | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-06-25 |
| 1477179414 | Hind Alharbi | Behavior Technician | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-06-24 |
| 1376163659 | Anna Jayne Hubbell | Counselor | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-04-16 |
| 1609495704 | Marlena Lee Kennedy | Counselor | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-04-09 |
| 1417576661 | Ashley Senf | Behavior Technician | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-04-08 |
| 1013543438 | De'sean Dean | Behavior Technician | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2020-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386262376 | Everwell Counseling Pllc | Clinic/Center | 306 E 18th Ave, Spokane, WA 99203-2217 | 2020-07-07 |
| 1326481375 | Peak Performance Psychiatry & Counseling | Clinic/Center | 1717 S Rustle St, Suite 212a, Spokane, WA 99224-2065 | 2013-04-09 |
| 1235478702 | Spokane Therapist | Clinic/Center | 1212 N Washington St Ste 206, Spokane, WA 99201-2441 | 2013-02-04 |
| 1942518865 | Passages Family Support A Nonprofit Corporation | Clinic/Center | 1700 S Assembly St Ste 300, Spokane, WA 99224-2116 | 2010-09-14 |
| 1871064238 | Hayley Stewart Licsw | Clinic/Center | 707 W 7th Ave Ste 270, Spokane, WA 99204-2821 | 2018-12-11 |
| 1942718598 | Climb LLC | Clinic/Center | 220 W Main Ave, Spokane, WA 99201-0112 | 2018-01-17 |
| 1790298610 | Charmed Counseling | Clinic/Center | 1405 E 12th Ave, Spokane, WA 99202-3527 | 2017-11-14 |
| 1336668656 | Derive Family Therapy | Clinic/Center | 12128 N Division St Unit 447, Spokane, WA 99218-1905 | 2017-09-18 |
| 1356863591 | Tami Haley Licsw | Clinic/Center | 707 W 7th Ave Ste 294, Spokane, WA 99204-2833 | 2017-07-10 |
| 1669924916 | Foundation Mental Health, LLC | Clinic/Center | 203 N Washington St, Suite 200, Spokane, WA 99201-0233 | 2016-11-02 |
| Find all providers in SPOKANE | ||||
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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.