| Distracted Excellence Llc | |
|
506 Hayward Ave Fruitland MD 21826-1421 | |
| (302) 858-6553 | |
| Not Available |
| Full Name | Distracted Excellence Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 506 Hayward Ave, Fruitland, Maryland |
| Authorized Official Name and Position | Lela Gwendolyn Simon (CEO) |
| Authorized Official Contact | 3028586553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Distracted Excellence Llc 506 Hayward Ave Fruitland MD 21826-1421 Ph: (302) 858-6553 | Distracted Excellence Llc 506 Hayward Ave Fruitland MD 21826-1421 Ph: (302) 858-6553 |
| NPI Number | 1912830456 |
|---|---|
| Provider Enumeration Date | 06/04/2026 |
| Last Update Date | 06/04/2026 |
| Certification Date | 06/04/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912830456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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