Excellacare Skilled Services Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

FACILITY # 638801 Issued in MI

Legal business name

EXCELLACARE SKILLED SERVICES INC.

Practice address

20853 Farmington Rd
Suite 200
Farmington Hills, MI 48336-5183

Phone

(248) 476-9091

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Susan Gwizdz, RN BSN MBA

Title

Administrator

Phone

(248) 476-9091

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Home health agency certification: CCN 237428

Legal name

EXCELLACARE SKILLED SERVICES INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 27, 1997

Last certification

Dec 6, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jan 18, 1994 in MI

Enrollment address

20853 Farmington Rd 200
Farmington Hills, MI 48336-5183

Listed as

Excellacare Skilled ServicesCCN 237428

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Jun 27, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1922005735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20853 FARMINGTON RD",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365183",
            "telephone_number": "248-476-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20853 FARMINGTON RD",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365183",
            "telephone_number": "248-476-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLACARE SKILLED SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "GWIZDZ",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-476-9091",
        "authorized_official_credential": "RN BSN MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "FACILITY # 638801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15  4087806",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Samantha Ewings
• Machaela Exantus
• Excellacare
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• Exclusive Elderly Resource Center
• Executive Edge International, Inc.
• Expert Consultancy LLC
• Talia Exposito

• Home Health Agency in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.