Excelsior Private Home Care LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

EXCELSIOR PRIVATE HOME CARE LLC

Practice address

270 Trelawney Dr
Covington, GA 30016-6819

Phone

(770) 385-8194

NPI assigned

Jun 12, 2013

Organization subpart

No

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

Authorized official

Name

Lilieth Verinica Perry

Title

Administrator

Phone

(770) 655-8360

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harbert Noel Green, RN

  • Registered Nurse
  • Covington, GA
  • NPI 1871838755
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370995200000",
    "number": "1619315694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 TRELAWNEY DR",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300166819",
            "telephone_number": "770-385-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 TRELAWNEY DR",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300166819",
            "telephone_number": "770-385-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR PRIVATE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "LILIETH",
        "authorized_official_middle_name": "VERINICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-655-8360"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Covington, GA
• Providers in Covington, GA by specialty
• Adolescent and Children Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.