Excel Community Behavioral Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EXCEL COMMUNITY BEHAVIORAL HEALTH SERVICES, LLC

Practice address

9780 N 56TH St Ste B
Temple Terrace, FL 33617-5508

Phone

(813) 422-5502

Fax

(813) 364-6474

NPI assigned

May 29, 2019

Last updated

Apr 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimerlyn Johnson, EDS

Title

Operations Adminstrator

Phone

(813) 422-5502

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1164080784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 BRUCE B DOWNS BLVD STE 328",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448616",
            "telephone_number": "813-422-5502",
            "fax_number": "813-364-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9780 N 56TH ST STE B",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336175508",
            "telephone_number": "813-422-5502",
            "fax_number": "813-364-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL COMMUNITY BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMERLYN",
        "authorized_official_title_or_position": "OPERATIONS ADMINSTRATOR",
        "authorized_official_telephone_number": "813-422-5502",
        "authorized_official_credential": "EDS"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Enriquez
• Erika N. Bethune, D.C., P.a.
• Roxana Escobar
• Esoterix Genetic Laboratories, LLC
• Elriane Miline Eugene, APRN
• Evelyn Exposito Gonzalez, MD
• Cortez Rafel Fabia, FNP
• Ola Fadaly, PT
• Alta Faison
• Linda Falzetta, ARNP

• Community/Behavioral Health Agency in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.