Excellence Community Rehabilitation Program LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

EXCELLENCE COMMUNITY REHABILITATION PROGRAM LLC

Doing business as

Ecrp
Excellence Community Residential Properties

Practice address

37025 La Contempo Ave
Palmdale, CA 93550-7351

Phone

(424) 789-0439

NPI assigned

Aug 16, 2022

Last updated

Feb 22, 2023By 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

Miss Octavia Askew, PH.D

Title

Program Director/Administrator

Phone

(424) 789-0439

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• ECRP Doing business as
• Excellence Community Residential Properties Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Octavia Antoinette Watkins, PH.D

  • Case Manager/Care Coordinator
  • Palmdale, CA
  • NPI 1053976811
  NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1184342099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E PALMDALE BLVD STE G",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507801",
            "telephone_number": "424-789-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37025 LA CONTEMPO AVE",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935507351",
            "telephone_number": "424-789-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE COMMUNITY REHABILITATION PROGRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "ASKEW",
        "authorized_official_first_name": "OCTAVIA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR/ADMINISTRATOR",
        "authorized_official_telephone_number": "424-789-0439",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADULT RESIDENTIAL FACILITY LICENSE",
            "identifier": "197610283",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@excellencecrp.com",
            "affiliation": "N",
            "address_1": "1607 E Palmdale Blvd Ste G",
            "city": "Palmdale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935507801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ECRP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Excellence Community Residential Properties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.