| The Excel Group | |
|
28671 Los Angeles Avenue Wellton AZ 85356-0179 | |
| (928) 785-9426 | |
| (928) 785-9462 |
| Full Name | The Excel Group |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 28671 Los Angeles Avenue, Wellton, Arizona |
| Authorized Official Name and Position | Caron A. Carr (CEO) |
| Authorized Official Contact | 9283410335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Excel Group 3250a E 40th St Yuma AZ 85365-7748 Ph: (928) 341-0335 | The Excel Group 28671 Los Angeles Avenue Wellton AZ 85356-0179 Ph: (928) 785-9426 |
| NPI Number | 1952481814 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952481814 | NPI | - | NPPES |
| 707185 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH-2037 (Arizona) | Primary |