EXCEL 4 LIFE, INC


Address: 1730 Carolina Ave, Washington, NC 27889-3315
Phone: 2522050381

EXCEL 4 LIFE, INC (NPI# 1669705596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669705596
Entity Type Organization
Organization Name EXCEL 4 LIFE, INC
Practice Address 1730 Carolina Ave
Washington
NC 27889-3315
Practice Telephone 2522050381
Practice Fax Number 2522050381
Mailing Telephone 2522050381
Mailing Fax Number 2522050381
Enumeration Date 2009-09-10
Last Update Date 2009-09-10
Authorized Official Name MARIO JACKSON (OWNER/DIRECTOR)
Authorized Official Telephone 2522050381
Authorized Official Credential B.A CRIMINAL JUS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children Residential Treatment Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1720211212 Excel 4 Life, Inc Community/Behavioral Health 149 N Market St, Washington, NC 27889-4947 2009-08-31
1487988788 Excel 4 Life, Inc Residential Treatment Facility, Emotionally Disturbed Children 2310 Cherry Run Rd, Washington, NC 27889-8366 2009-09-21

Office Location

Street Address 1730 CAROLINA AVE
City WASHINGTON
State NC
Zip Code 27889-3315

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407819212 Timothy Richard Klugh Optometrist 1730 Carolina Ave, Washington, NC 27889-3315 2006-04-11
1336432301 Albemarle Eye Center, Pllc Durable Medical Equipment & Medical Supplies 1730 Carolina Ave, Washington, NC 27889-3315 2011-05-24
1942377114 Excel for Life, LLC Residential Treatment Facility, Emotionally Disturbed Children 1730 Carolina Ave, Washington, NC 27889-3315 2006-11-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336786326 Coastal Solutions LLC Counselor 51 Hwy 33 W, Chocowinity, NC 27889 2019-12-09
1952946246 Emily Hodges Hall Pharmacy 627 E 12th Street, Washington, NC 27889 2019-11-11
1649780032 John Bailey Bland II Chiropractor 610 W. 15th. St., Washington, NC 27889 2017-10-11
1255780136 County of Beaufort Ambulance 1420 Highland Drive, Washington, NC 27889 2016-06-10
1790175917 Inner Coastal Orthotics and Prosthetics Orthotist 1102 North Brown St., Washington, NC 27889 2015-01-26
1972847390 Country Living Guest Home #7 Community/Behavioral Health 207 W 11th St, Washington, NC 27889 2012-11-26
1104182005 Country Living Guest Home #8 Community/Behavioral Health 618 Plant St, Washington, NC 27889 2012-04-04
1881986537 Mary Lewis Scarbraugh Social Worker 408 E. 11th St., Washington, NC 27889 2011-05-12
1952615825 Country Living Guest Home #6 Community/Behavioral Health 252 Dan Taylor Rd, Washington, NC 27889 2010-08-03
1376784371 Jennifer Michele Richardson Nurse Practitioner 1207 Highland Drive, Washington, NC 27889 2009-03-20
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.
Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285985069 Center for Youth Excellence Residential Treatment Facility, Emotionally Disturbed Children 1409 Kearny St Ne, Washington, DC 20017-2957 2012-09-20
1558547315 Excel for Life (cedar Home) Residential Treatment Facility, Emotionally Disturbed Children 108 Cedar Cir, Washington, NC 27889-9506 2008-01-11
1295917870 Healthplus Therapeutic Services Inc Residential Treatment Facility, Emotionally Disturbed Children 304 W 15th St, Washington, NC 27889-3650 2007-12-05
1932309556 Treasured Care, LLC Residential Treatment Facility, Emotionally Disturbed Children 201 Red Oak Dr, Washington, NC 27889-9345 2007-07-22
1487988788 Excel 4 Life, Inc Residential Treatment Facility, Emotionally Disturbed Children 2310 Cherry Run Rd, Washington, NC 27889-8366 2009-09-21
1841524147 Excel 4 Life Inc. Residential Treatment Facility, Emotionally Disturbed Children 108 Cedar Cir, Washington, NC 27889-9506 2009-09-21
1770769481 Dream Provider Care Services Residential Treatment Facility, Emotionally Disturbed Children 1255 Highland Dr, Washington, NC 27889-3405 2008-01-11
1942377114 Excel for Life, LLC Residential Treatment Facility, Emotionally Disturbed Children 1730 Carolina Ave, Washington, NC 27889-3315 2006-11-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023617255 Creative Helping Hands LLC Residential Treatment Facility, Emotionally Disturbed Children 478 Green Lake Rd, Rockingham, NC 28379-7850 2020-10-19
1083237986 Revive Housing LLC Residential Treatment Facility, Emotionally Disturbed Children 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 2020-05-26
1457998627 Re Health Group Residential Treatment Facility, Emotionally Disturbed Children 1102 Groves St, Kings Mountain, NC 28086-2232 2019-12-05
1821631532 Marquita Latrice Walls Residential Treatment Facility, Emotionally Disturbed Children 1565 Longbranch Rd, Grover, NC 28073-9599 2019-10-25
1699233866 A Brighter Path LLC Residential Treatment Facility, Emotionally Disturbed Children 120 Jetter Rd, Grover, NC 28073-9687 2019-03-06
1821562224 Carter Clinic, Pa Residential Treatment Facility, Emotionally Disturbed Children 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 2019-01-18
1659842607 Gervonia Robinson Residential Treatment Facility, Emotionally Disturbed Children 1714 Aster Ln, Gastonia, NC 28054-8303 2018-12-16
1679058440 Miracle Houses Inc Residential Treatment Facility, Emotionally Disturbed Children 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 2018-09-27
1174048078 A Safe Place Community Housing, LLC Residential Treatment Facility, Emotionally Disturbed Children 2049 Highland St, Charlotte, NC 28208-4909 2017-08-11
1104346881 Inspiration for Us Residential Treatment Facility, Emotionally Disturbed Children 1205 W Mountain St, Kernersville, NC 27284-2173 2017-06-22
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Competitor

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City WASHINGTON
Zip Code 27889

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Dataset Information

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.

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