EXCELSIOR INTEGRATED CARE CENTER LLC (NPI# 1326672692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326672692 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR INTEGRATED CARE CENTER LLC |
| Practice Address |
3910 W. Indian Trail Rd Spokane WA 99208-4739 |
| Mailing Address |
3754 W Indian Trail Rd Spokane WA 99208-4736 |
| Practice Telephone | 5095593100 |
| Practice Fax Number | 5093287582 |
| Mailing Telephone | 5095593100 |
| Mailing Fax Number | 5093287582 |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | DOVIE BRITTON (CONTRACTING AND CREDENTIALING COORD) |
| Authorized Official Telephone | 5095593132 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EXCELSIOR INTEGRATED CARE CENTER LLC | 159 S Lincoln St Ste 225, Spokane, WA 99201-4418 |
| Street Address |
3910 W. INDIAN TRAIL RD |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-4739 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588208532 | Family Community Services, Inc. | Community/Behavioral Health | 422 W Riverside Ave Ste 330, Spokane, WA 99201-0307 | 2019-11-03 |
| 1790341659 | Compassionate Addiction Treatment | Community/Behavioral Health | 215 W 2nd Ave, Spokane, WA 99201-3605 | 2019-05-16 |
| 1700396314 | Seneca Family of Agencies | Community/Behavioral Health | 811 E Sprague Ave Ste B2, Spokane, WA 99202-2105 | 2017-10-09 |
| 1760921399 | Jeff Bafus Counseling & Consultation | Community/Behavioral Health | 3214 W Grandview Ave, Spokane, WA 99224-5524 | 2017-02-15 |
| 1942673934 | Darci Sheridan Counseling Pllc | Community/Behavioral Health | 618 E Liberty Ave, Spokane, WA 99207-2856 | 2015-11-12 |
| 1790153682 | Pioneer Human Services | Community/Behavioral Health | 910 W Boone Ave Ste 201, Spokane, WA 99201-5029 | 2015-09-09 |
| 1770975005 | Properties of Healing | Community/Behavioral Health | 6119 S Magnolia St, Spokane, WA 99223-8364 | 2015-02-24 |
| 1528450152 | New Developed Nations, LLC | Community/Behavioral Health | 631 S Richard Allen Ct, Spokane, WA 99202-2345 | 2015-02-18 |
| 1811386972 | Brecht & Woods Inc | Community/Behavioral Health | 405 E Hartson Ave Ste 4, Spokane, WA 99202-1329 | 2015-01-13 |
| 1689062366 | Lilac Counseling Services, LLC | Community/Behavioral Health | 3508 E 31st Ave, Spokane, WA 99223-3707 | 2015-01-02 |
| Find all providers in SPOKANE | ||||
Please comment or provide details below to improve the information on EXCELSIOR INTEGRATED CARE CENTER LLC.
| 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.