EXCELSIOR YOUTH CENTER (NPI# 1982995288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982995288 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR YOUTH CENTER |
| 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 | 2011-04-21 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | MS. ANDREW R HILL (PRESIDENT/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5093287041 |
| Authorized Official Credential | MS, LMHC, CMHS, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1007885 | 05 | |
| WA | 2015145 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104124148 | Excelsior Youth Center | Community Based Residential Treatment Facility, Mental Illness | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2011-02-28 |
| 1326267055 | Excelsior Youth Center | Clinic/Center | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2007-04-24 |
| 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 | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
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|---|---|---|---|---|
| 1629278932 | Partners With Families and Children | Public Health or Welfare | 1321 W Broadway Ave, Spokane, WA 99201-2053 | 2007-07-24 |
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| 1417329715 | Karen Laumattus | Public Health or Welfare | 1510 40th St, Anacortes, WA 98221-3509 | 2015-10-26 |
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| 1396142816 | Yakima Health District | Public Health or Welfare | 1210 Ahtanum Ridge Dr, Union Gap, WA 98903-1813 | 2014-11-26 |
| 1821494279 | Kimberly D. Glace-krause | Public Health or Welfare | 1537 Primrose Ct, Lynden, WA 98264-9353 | 2014-11-13 |
| 1295136083 | Massa Wellness LLC | Public Health or Welfare | 10 Lake Shore Plz, Kirkland, WA 98033-6110 | 2014-09-11 |
| 1093120743 | Washington State Department of Health | Public Health or Welfare | 310 Israel Rd Se, Tumwater, WA 98501-5567 | 2014-06-20 |
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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.