EXCELSIOR HOME 1 INC. (NPI# 1891917191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891917191 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR HOME 1 INC. |
| Practice Address |
129 Virginia Park Detroit MI 48202 |
| Mailing Address |
P.o.box 11387 Detroit MI 48202 |
| Practice Telephone | 3138745594 |
| Practice Fax Number | 2482080024 |
| Mailing Telephone | 3138745404 |
| Mailing Fax Number | 2482080024 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-08-15 |
| Authorized Official Name | MR. KATHLEEN DAVIS (ADMINISTRATOR) |
| Authorized Official Telephone | 3138745404 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MI | Residential Treatment Facilities |
| Street Address |
129 VIRGINIA PARK |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
| 1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
| 1851875371 | People Community of Michigan Afc Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 16829 Monica St, Detroit, MI 48221-2969 | 2018-09-20 |
| 1083169502 | Emmanuel House | Community Based Residential Treatment Facility, Mental Illness | 14750 Saint Marys St, Detroit, MI 48227-1862 | 2016-08-25 |
| 1407234586 | Karen Frederick LLC | Community Based Residential Treatment Facility, Mental Illness | 5781 Beaconsfield St, Detroit, MI 48224-3157 | 2015-05-11 |
| 1861882821 | Inclusive Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 4535 Chrysler Dr, Detroit, MI 48201-1954 | 2015-01-29 |
| 1306257852 | Victory Unto Salvation Faith Ministries Dba The Philip House Mission | Community Based Residential Treatment Facility, Mental Illness | 18066 James Couzens Fwy, 2305 Pasadena, Detroit, MI 48235-2646 | 2014-05-17 |
| 1437586039 | Read All About It Literacy Center | Community Based Residential Treatment Facility, Mental Illness | 2727 Second Ave Suite 124, Detroit, MI 48201-4025 | 2013-09-27 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| 1356648034 | Shining Star Ll | Community Based Residential Treatment Facility, Mental Illness | 533 Mcdougall St, Detroit, MI 48207-3912 | 2011-02-16 |
| Find all providers in DETROIT | ||||
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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.