NPIMap

Organization Active NPI

Excel Learning Center

Doing business as Excel For Life, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Washington, NC
National Provider Identifier
1902024144
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
050314 Issued in NC
Legal business name
EXCEL LEARNING CENTER
Doing business as
Excel For Life, LLC
Practice address
1724 Carolina Ave
Washington, NC 27889-3315
Phone
(252) 946-4243
Fax
(252) 975-8049
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mario Jermaine Jackson, CRIMINAL JUSTICE DEG
Title
Director
Phone
(252) 205-0381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 050314 NC Primary

Addresses

Primary practice location

1724 Carolina Ave
Washington, NC 27889-3315

Mailing address

1724 Carolina Ave
Washington, NC 27889-3315
Phone (252) 946-4243

Other names 1

  • Excel For Life, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Excel for Life LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902024144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893315",
            "telephone_number": "252-946-4243",
            "fax_number": "252-975-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893315",
            "telephone_number": "252-946-4243",
            "fax_number": "252-975-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL LEARNING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "JERMAINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-205-0381",
        "authorized_official_credential": "CRIMINAL JUSTICE DEG"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "050314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel For Life, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, NC

Sources for this page

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