Excel Residential Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EXCEL RESIDENTIAL HOME

Practice address

5503 S Manhattan PL
Los Angeles, CA 90062-2622

Phone

(213) 369-1383

NPI assigned

Jul 15, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Watts, ADMINISTRATOR

Title

Administrator

Phone

(213) 369-1383

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1164269387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 S MANHATTAN PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900622622",
            "telephone_number": "213-369-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 S MANHATTAN PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900622622",
            "telephone_number": "213-369-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL RESIDENTIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-14",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-369-1383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.